DR. Wallace C Hodge, DMD

NPI #1982772679 in Beaverton, Oregon

Provider Information

NPI Number: 1982772679
Entity Type: Individual
Name: DR. Wallace C Hodge, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DMD
Enumeration Date: Dec 1, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 14425 SW ALLEN BLVD
City: Beaverton
State: Oregon
ZIP Code: 97005-4402
Phone: (503) 520-0707

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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