Individual
DR. BRENT WARREN MOODY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4320 MCAULEY BLVD, OKLAHOMA CITY, OK 73120-8364
(405) 755-8020
Mailing address
4320 MCAULEY BLVD, OKLAHOMA CITY, OK 73120-8364
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
5120
OK
Other
Enumeration date
10/10/2005
Last updated
07/08/2007
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