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1578780979
JERRY WAYNE MOODY
TUMWATER, WA
NPI
1578780979
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: WA DE00006219)
Enumeration Date
2007-04-19
Last Update Date
2007-07-08
Business Address
Dr. JERRY WAYNE MOODY D.D.S.
501 TYEE DR SW
TUMWATER, WA 98512-7313
Phone number: 360-352-5100
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Mailing Address
Dr. JERRY WAYNE MOODY D.D.S.
501 TYEE DR SW
TUMWATER, WA 98512-7313
Phone number: 360-352-5100
Copy
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