Stacy Renae Moody in Granite City - General Practice
Stacy Renae Moody - NPI 1700984317
Stacy Renae Moody is a General Practice in Granite City, Illinois. Stacy Renae Moody practices all healthcare services and medical treatments related to General Practice. The NPI Number for Stacy Renae Moody is 1700984317. The last update date is 2013-10-30.
Stacy Renae Moody's current location address is 3120 Maryville Rd, Granite City, Illinois. You can contact this provider via phone number 6187979940. The mailing address for Stacy Renae Moody is 3120 Maryville Rd, Granite City, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stacy Renae Moody |
|---|---|
| Address | 3120 Maryville Rd, Granite City, Illinois |
| Phone Number | 6187979940 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1700984317 |
|---|---|
| Provider Enumeration Date | 2006-09-20 |
| Last Updated Date | 2013-10-30 |
Provider Mailing Address Detail
| Address | 3120 Maryville Rd |
|---|---|
| City | Granite City |
| State | Illinois (IL) |
| Post Code | 620405189 |
| Phone Number | 6187979940 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 19026581 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the unique 10-digit identification code issued to Stacy Renae Moody by the Centers for Medicare & Medicaid Services?
The Stacy Renae Moody has been assigned the NPI (National Provider Identifier) 1700984317 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you share the physical location details of Stacy Renae Moody?
The Stacy Renae Moody is situated at 3120 Maryville Rd, in the city of Granite City, state of IL, with the zip code 620405189.
What is the area of specialization for Stacy Renae Moody, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Stacy Renae Moody is General Practice, and the corresponding taxonomy code that categorizes this area of expertise is 1223G0001X.
When was the Stacy Renae Moody's 1700984317 issued?
The Stacy Renae Moody's 1700984317 was issued on 2006-09-20.
When was the Stacy Renae Moody's information last updated?
The Stacy Renae Moody's information was last updated on 2013-10-30.
NPI Number: 1457354235
Address: Po Box 636256 Central Credentialing, Cincinnati, OH