Provider Demographics
NPI:1396821575
Name:HODGES ORTHODONTICS
Entity Type:Organization
Organization Name:HODGES ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:HODGES
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD MS
Authorized Official - Phone:662-407-0713
Mailing Address - Street 1:141A S COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-4502
Mailing Address - Country:US
Mailing Address - Phone:662-407-0713
Mailing Address - Fax:662-407-0714
Practice Address - Street 1:141A S COMMERCE ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-4502
Practice Address - Country:US
Practice Address - Phone:662-407-0713
Practice Address - Fax:662-407-0714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty