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Individual
MR. JEREMY L HODGE
Active
Individual
MR. JEREMY L HODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0101413727
VA
1223G0001X
General Practice Dentistry
D3808
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6K216
BLUE CROSS
—
01
—
806913500
DENTAQUEST
VA
Enumeration date
11/28/2006
Last updated
02/20/2024
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