Individual
DR. JOHN BRYANT MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(812) 218-8926
(812) 218-8930
Mailing address
2215 PORTLAND AVE, LOUISVILLE, KY 40212-1033
(812) 218-8926
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5990
KY
Other
Enumeration date
09/05/2006
Last updated
01/18/2017
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