| NPI | 1023329620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN P MOODY Dentist 206-285-1338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WA DE00010023) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2010-06-29 |