Organization
BRENT W. MOODY D.D.S., PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT W. MOODY D.D.S. (PRESIDENT)
(405) 755-8020
Entity
Organization
Contact information
Practice address
4320 MCAULEY BLVD, OKLAHOMA CITY, OK 73120-8386
(405) 755-8020
Mailing address
4320 MCAULEY BLVD, OKLAHOMA CITY, OK 73120-8386
(405) 755-8020
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
5120
OK
Other
Enumeration date
04/22/2008
Last updated
04/22/2008
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