Individual
SUSAN HELAINE HODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
25501 BRAINARD AVENUE, FORT GORDON, GA 30905
(706) 787-7050
Mailing address
25501 BRAINARD AVENUE, FORT GORDON, GA 30905
(706) 787-7050
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN013407
GA
1223G0001X
General Practice Dentistry
Primary
DN013407
GA
Other
Enumeration date
02/20/2007
Last updated
05/11/2018
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