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NPI Code Detail

MEDICARE: DR. DUSTIN ROY COVERT DODDS D.M.D.

MEDICARE:  DR. DUSTIN ROY COVERT DODDS  D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry64207CA

General Provider Information

NPI Number : 1306132469
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DUSTIN ROY COVERT DODDS D.M.D.
Provider Business Mailing Address
First Line : 5580 E 2ND ST
Second Line : SUITE 202
City : LONG BEACH
State : CA
Zip : 90803-3946
Country : US
Telephone Number : 562-439-0754
Fax Number :
Provider Business Practice Location Address
First Line : 5580 E 2ND ST
Second Line : SUITE 202
City : LONG BEACH
State : CA
Zip : 90803-3946
Country : US
Telephone Number : 562-439-0754
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2011
Last Update Date : 01/28/2021

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Directions to “ DR. DUSTIN ROY COVERT DODDS D.M.D.” Practice Location

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