Individual
MICHAEL S MOODY
Active
Individual
MICHAEL S MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
9433
AZ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
S2-155C
NV
390200000X
Student in an Organized Health Care Education/Training Program
DRP1048
FL
Other
Enumeration date
08/08/2012
Last updated
04/09/2019
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