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General NPI Number Information
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NPI Number | 1336716620
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Entity Type | Organization
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Legal Business Name | JODI TODD RDHAP, INC.
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Dates
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Enumeration Date | 06/07/2021
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Last Update Date | 06/07/2021
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Provider Practice Location Address
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Address Line | 244 HOSPITAL DR STE B
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City | UKIAH
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State | CA
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Zip | 95482-4557
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Country | US
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Telephone | 707-467-9733
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Fax |
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Provider Business Mailing Address
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Address Line | 561 SARATOGA CT
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City | UKIAH
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State | CA
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Zip | 95482-4187
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Country | US
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Telephone | 707-272-4426
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JODI TODD
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Credential | RDHAP
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Telephone | 707-272-4426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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