DR. Beau G Moody, DMD
NPI #1780917823 in Edwardsville, Illinois
Provider Information
- NPI Number
- 1780917823
- Entity Type
- Individual
- Name
- DR. Beau G Moody, DMD
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist
- Credential
- DMD
- Enumeration Date
- Sep 8, 2009
- Last Updated
- Jun 15, 2021
Practice Location
- Address
- 1811 LINDENWOOD AVE
- City
- Edwardsville
- State
- Illinois
- ZIP Code
- 62025-2580
- Phone
- (618) 659-0456
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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