Individual
DONALD A. DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
336 W 920 N, OREM, UT 84057-3042
(801) 225-8060
(801) 434-5403
Mailing address
336 W 920 N, OREM, UT 84057-3042
(801) 225-8060
(801) 434-5403
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
133432
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528828240001
—
UT
Enumeration date
07/01/2006
Last updated
07/08/2007
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