Individual
DR. EDWARD MORRIS MOODY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
404 E TEXAS AVE, RAYNE, LA 70578-6435
(337) 334-2967
(337) 334-2967
Mailing address
404 E TEXAS AVE, RAYNE, LA 70578-6435
(337) 334-2967
(337) 334-2967
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5490
LA
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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