Individual
DR. LARRY KENNETH HODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
321 N 22ND ST, LAFAYETTE, IN 47904-2601
(765) 463-7897
(765) 447-1552
Mailing address
321 N 22ND ST, LAFAYETTE, IN 47904-2601
(765) 463-7897
(765) 447-1552
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12005653
IN
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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