Individual
DR. JOHN R DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD,MS
Contact information
Practice address
1440 28TH ST, SUITE 1, BOULDER, CO 80303-1030
(303) 447-0460
(303) 447-9578
Mailing address
1440 28TH ST, SUITE 1, BOULDER, CO 80303-1030
(303) 447-0460
(303) 447-9578
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
CO7489
CO
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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