Provider Demographics
NPI:1639395254
Name:HODD, LORRIE KAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LORRIE
Middle Name:KAY
Last Name:HODD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S 5TH ST
Mailing Address - Street 2:SUITE 1475
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55402-4200
Mailing Address - Country:US
Mailing Address - Phone:612-332-1255
Mailing Address - Fax:612-338-3721
Practice Address - Street 1:150 S 5TH ST
Practice Address - Street 2:SUITE 1475
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-4200
Practice Address - Country:US
Practice Address - Phone:612-332-1255
Practice Address - Fax:612-338-3721
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND10117122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist