NPI 1033204094

Michael Derrick Moody, DDS

Practitioner Oral and Maxillofacial Surgery (Dentist) Bartlesville, OK

Practice location

Address: 215 SE Howard Ave, Bartlesville, OK 74006-2204
Phone: (918) 333-9155
Fax: (918) 333-9142
Mailing address: 9990 W 26th Ave Suite 100, Lakewood, CO 80215-1581

Registered specialties

Oral and Maxillofacial Surgery (Dentist) Primary

Dental Providers Taxonomy 1223S0112X Licence 7289 (OK)

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Registry record

NPI: 1033204094
Entity type: Individual
Sex (as registered): Male
NPI issued: 4 Oct 2006
Record last updated: 10 Apr 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.