Provider Demographics
NPI:1184735839
Name:HODD, JEFFREY ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:ALAN
Last Name:HODD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4323 HILL STREET
Mailing Address - Street 2:USA DENTAC
Mailing Address - City:FT JACKSON
Mailing Address - State:SC
Mailing Address - Zip Code:29207-6022
Mailing Address - Country:US
Mailing Address - Phone:803-751-6213
Mailing Address - Fax:803-751-6886
Practice Address - Street 1:4323 HILL STREET
Practice Address - Street 2:USA DENTAC
Practice Address - City:FT JACKSON
Practice Address - State:SC
Practice Address - Zip Code:29207-6022
Practice Address - Country:US
Practice Address - Phone:803-751-6213
Practice Address - Fax:803-751-6886
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10754122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist