Organization
MIKE MOODY LLC
Active
Other names
Uptown Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL THOMAS MOODY DDS (DENTIST)
(503) 223-5040
Entity
Organization
Contact information
Practice address
2330 NW FLANDERS ST STE 204, PORTLAND, OR 97210-3460
(503) 223-5040
Mailing address
2330 NW FLANDERS ST STE 204, PORTLAND, OR 97210-3460
(503) 223-5040
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/25/2024
Last updated
09/25/2024
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