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General NPI Number Information
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NPI Number | 1184841116
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Entity Type | Individual
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Provider Name | PENNY J DODSON D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 4330 GOLDEN CENTER DRIVE SUITE A
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City | PLACERVILLE
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State | CA
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Zip | 95667
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Country | US
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Telephone | 530-642-8614
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Fax | 530-642-9314
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Provider Business Mailing Address
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Address Line | 4330 GOLDEN CENTER DRIVE SUITE A
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City | PLACERVILLE
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State | CA
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Zip | 95667-6259
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Country | US
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Telephone | 530-642-8614
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Fax | 530-642-9314
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 42913
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License Number State | CA
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