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General NPI Number Information
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NPI Number | 1366655078
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Entity Type | Organization
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Legal Business Name | ROBERT G HODOUS DDS LTD
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2630 E CITIZENS DR SUITE 8
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4797
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Country | US
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Telephone | 479-582-1100
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Fax | 479-587-1171
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Provider Business Mailing Address
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Address Line | 2630 E CITIZENS DR SUITE 8
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-4797
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Country | US
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Telephone | 479-582-1100
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Fax | 479-587-1171
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Authorized Official
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Title or Position | PATIENT COORDINATOR
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Name | MRS. RHONDA A LILES
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Credential |
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Telephone | 479-582-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3251
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License Number State | AR
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