Beau Moody, DMD
NPI 1780917823 · on the registry since 2009 · sole proprietor
Practice
- Address
- 1811 Lindenwood Ave
Edwardsville, IL 62025 - Phone
- (618) 659-0456
- Organisation at this address
- Edwardsville Family Dentist
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 4
Additional practice sites
- 212 E Market St, Troy, IL
Registry record
- Primary taxonomy
- Dentist
122300000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-06-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois