Individual
DR. JEANNIE MARIE MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D,M.D
Contact information
Practice address
5407 BASSWOOD BLVD, SUITE 107, FORT WORTH, TX 76137-6900
(817) 348-0910
Mailing address
5407 BASSWOOD BLVD, SUITE 107, FORT WORTH, TX 76137-6900
(817) 348-0910
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
24299
TX
Other
Enumeration date
01/05/2009
Last updated
01/05/2009
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