Individual
JASON DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3201 UNIVERSITY DR E STE 170, BRYAN, TX 77802-3476
(979) 774-1255
Mailing address
170 CENTURY SQUARE DR APT 255, COLLEGE STATION, TX 77840-4172
(210) 792-0762
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
40058
TX
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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