Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BEAU G MOODY, DMD
Active Sole ProprietorDR. BEAU G MOODY, DMD is a Dentist healthcare provider located in EDWARDSVILLE, Illinois. NPI 1780917823 is currently active in the NPPES registry. Verify at CMS.
Dentist · EDWARDSVILLE, IL
Registration Details
- NPI Number
- 1780917823
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 8, 2009 (16.749815402721 yrs)
- Last Updated
- Jun 15, 2021
- License
-
019.028093 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1811 LINDENWOOD AVEEDWARDSVILLE, IL, 620252580Browse IL providers · Browse ZIP 62025
- Phone
- 6186590456
- Primary Specialty
-
Dentist
122300000X
Other Dentist Providers in EDWARDSVILLE, IL
| Name | Credential | NPI |
|---|---|---|
| DR. JEFFREY VERNON NOLL | D.D.S. | 1114076049 |
| DR. TALETTA ANN WATSON | D.M.D. | 1265586960 |
| MRS. JOY E BEDWELL | DMD PC | 1023154119 |
| DR. CHARLES WILLIAMS | DMD | 1497872626 |
| DR. REBECCA LYNN DUNN | D.M.D. | 1992823934 |
| DR. PAUL THOMAS KUNDRICK | DDS | 1730378704 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.