Individual
DR. MICHAEL DERRICK MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
215 SE HOWARD AVE, BARTLESVILLE, OK 74006-2204
(918) 333-9155
(918) 333-9142
Mailing address
9990 W 26TH AVE, SUITE 100, LAKEWOOD, CO 80215-1581
(303) 232-4422
(303) 232-8795
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7289
OK
Other
Enumeration date
10/04/2006
Last updated
04/10/2024
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