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Individual

DR. CHASE WINSTON HODGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
501 N 6TH ST, BLYTHEVILLE, AR 72315-2407
(870) 763-2100
Mailing address
501 N 6TH ST, BLYTHEVILLE, AR 72315-2407

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4183
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4183
ARKANSAS DENTAL LICENSE
AR
Enumeration date
06/23/2017
Last updated
06/23/2017
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