Organization
HODOSH DENTAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEX HODOSH DMD (DR. -MANAGER)
(401) 467-4600
Entity
Organization
Contact information
Practice address
243 ELMWOOD AVE, PROVIDENCE, RI 02907-1547
(401) 467-4600
(401) 781-9854
Mailing address
243 ELMWOOD AVE, PROVIDENCE, RI 02907-1547
(401) 467-4600
(401) 781-9854
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
1854
RI
1223E0200X
Endodontics
Primary
2280
RI
1223G0001X
General Practice Dentistry
1854
RI
1223G0001X
General Practice Dentistry
2280
RI
1223P0106X
Oral and Maxillofacial Pathology Dentistry
2280
RI
1223P0300X
Periodontics
2280
RI
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2280
RI
122400000X
Denturist
2280
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
780979
UNITED CONCORDIA
RI
01
—
8982-7
BLUE CROSS BLUE SHIELD RI
RI
01
—
DEN999
MASHENTUCKET-PEQUOT
RI
01
—
RG0053
BLUE CROSS BLUE SHEILD MA
MA
Enumeration date
12/12/2006
Last updated
05/26/2009
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