Individual
KEITH A DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
336 W 920 N, OREM, UT 84057-3042
(801) 225-8060
Mailing address
336 W 920 N, OREM, UT 84057-3042
(801) 225-8060
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7395098-9922
UT
Other
Enumeration date
07/07/2009
Last updated
07/07/2009
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