Justin Moody, Dds, A Professional Corporation | |
5756 Pacific Ave Ste 40 Stockton CA 95207-5156 | |
(209) 390-4923 | |
Not Available |
Full Name | Justin Moody, Dds, A Professional Corporation |
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Speciality | Dentist - General Practice |
Location | 5756 Pacific Ave Ste 40, Stockton, California |
Authorized Official Name and Position | Justin Moody (OWNER) |
Authorized Official Contact | 2093904923 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Justin Moody, Dds, A Professional Corporation 5756 Pacific Ave Ste 40 Stockton CA 95207-5156 Ph: (209) 390-4923 | Justin Moody, Dds, A Professional Corporation 5756 Pacific Ave Ste 40 Stockton CA 95207-5156 Ph: (209) 390-4923 |
NPI Number | 1407530850 |
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Provider Enumeration Date | 06/14/2023 |
Last Update Date | 06/14/2023 |
Identifier | Type | State | Issuer |
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1407530850 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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