Individual
BENJAMIN DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
FORT DEFIANCE INDIAN HOSPITAL BOARD INC., CORNER OF ROUTES N12 & N7, FORT DEFIANCE, AZ 86504
(928) 729-8097
Mailing address
PO BOX 2035, WINDOW ROCK, AZ 86515-2035
(505) 710-6592
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2019-0276
NM
Other
Enumeration date
05/20/2016
Last updated
09/06/2019
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