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General NPI Number Information
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NPI Number | 1790900348
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Entity Type | Organization
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Legal Business Name | JOHN D DODSON DDS INC
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 845 WAINEE ST SUITE 201
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City | LAHAINA
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State | HI
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Zip | 96761
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Country | US
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Telephone | 808-667-7033
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1671
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City | LAHAINA
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State | HI
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Zip | 96767
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Country | US
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Telephone | 808-667-7033
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN D DODSON
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Credential | DDS
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Telephone | 808-667-7033
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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 | 1052
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License Number State | HI
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