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Organization

BRUCE S. DODGE, D.M.D., INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRUCE S. DODGE D.M.D. (OWNER)
(818) 846-9041
Entity
Organization

Contact information

Practice address
2800 W MAGNOLIA BLVD, BURBANK, CA 91505-3036
(818) 846-9041
(818) 842-4065
Mailing address
2800 W MAGNOLIA BLVD, BURBANK, CA 91505-3036
(818) 846-9041
(818) 842-4065

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
28436
CA
1223G0001X
General Practice Dentistry
29485
CA
1223G0001X
General Practice Dentistry
41791
CA
1223G0001X
General Practice Dentistry
45014
CA

Other

Enumeration date
04/30/2014
Last updated
04/30/2014
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