Individual
DR. DENNIS MICHAEL MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30.015484
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
341290190
T.I.N.
—
Enumeration date
05/04/2007
Last updated
07/08/2007
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