Individual
DR. SCOTT JEFFREY HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
3366 BURTON ST SE, GRAND RAPIDS, MI 49546-4353
(616) 949-3541
Mailing address
3366 BURTON ST SE, GRAND RAPIDS, MI 49546-4353
(616) 949-3541
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
2901014422
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2901014422
STATE DENTAL LICENSE
MI
Enumeration date
03/26/2007
Last updated
07/08/2007
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