Individual
DAVID MATTHEW DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1461 BROADWAY STREET, SUITE A, LONGVIEW, WA 98632-3724
(855) 433-6825
Mailing address
6950 NE CAMPUS WAY, HILLSBORO, OR 97124-5611
(855) 433-6825
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
60890263
WA
122300000X
Dentist
Primary
DE60890263
WA
Other
Enumeration date
11/06/2018
Last updated
01/03/2019
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