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Individual

ERNEST W MOODY JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
10 E SCHOOL HOUSE LN, PHILADELPHIA, PA 19144-2235
(215) 848-6446
(215) 848-7202
Mailing address
10 E SCHOOL HOUSE LN, PHILADELPHIA, PA 19144-2235
(215) 848-6446
(215) 848-7202

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS023581L
PA

Other

Enumeration date
06/02/2008
Last updated
06/02/2008
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