Individual provider · Type 1 NPI

John R. Dodge, DMD, MS

Periodontics · Boulder, CO

NPI number 1629190194 Active

Practice location

1440 28th St, Suite 1
Boulder, CO 80303-1030

Call (303) 447-0460 Map

Fax (303) 447-9578

Specialties and licenses

TaxonomyCodeLicense
Periodontics Primary 1223P0300XCO7489 (CO)

Periodontics: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.

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About NPI 1629190194

John R. Dodge, DMD, MS's National Provider Identifier is 1629190194, issued on Apr 4, 2007. The primary taxonomy on file is Periodontics (1223P0300X), and the practice location is in Boulder, CO. The record was last updated on Jul 8, 2007.