Moody, Carolyn S

Moody, Carolyn S is an individual health care provider with primary practice located at 303 S 4Th St Suite 200, Danville KY 40422-2004. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is her primary health care specialty. Moody, Carolyn S can be contacted via phone (859) 236-8448.

Contact Information

Primary practice address
303 S 4Th St Suite 200 Danville KY 40422-2004
Phone: (859) 236-8448
Fax: (859) 239-8909
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 5693 Kentucky
Dental Providers / Pediatric Dentistry 1223P0221X 5693 Kentucky

Profile Details

NPI number 1093799819
LBN Legal business name Moody, Carolyn S
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2005
Last updated Jan 9th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093799819 NPPES
Kentucky MEDICAID 45601101
Kentucky MEDICAID 60056934

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