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NPI Code Detail

MEDICARE: DR. CYNTHIA ELOIS HODGE DMD,MPH,MPA

MEDICARE: DR. CYNTHIA ELOIS HODGE DMD,MPH,MPA
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
1122300000XDentist009324CT
21223D0001XPublic Health Dentistry009324CT

General Provider Information

NPI Number : 1922287622
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CYNTHIA ELOIS HODGE DMD,MPH,MPA
Provider Business Mailing Address
First Line : 180 BRITTANY FARMS RD
Second Line :
City : NEW BRITAIN
State : CT
Zip : 06053-1144
Country : US
Telephone Number : 860-679-3470
Fax Number : 860-670-1066
Provider Business Practice Location Address
First Line : 12 WESTON ST
Second Line :
City : HARTFORD
State : CT
Zip : 06120-1504
Country : US
Telephone Number : 860-293-3101
Fax Number : 860-293-3117
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/30/2007
Last Update Date : 10/30/2007

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