DR. Jerry Wayne Moody, D.D.S.

NPI #1578780979 in Tumwater, Washington

Provider Information

NPI Number: 1578780979
Entity Type: Individual
Name: DR. Jerry Wayne Moody, D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: D.D.S.
Enumeration Date: Apr 19, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 501 TYEE DR SW
City: Tumwater
State: Washington
ZIP Code: 98512-7313
Phone: (360) 352-5100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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