Provider Demographics
NPI:1457566572
Name:HODGES, ANDREW CHARLES (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:CHARLES
Last Name:HODGES
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:1010 W RALPH M HALL PKWY STE 101
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6656
Mailing Address - Country:US
Mailing Address - Phone:972-771-9500
Mailing Address - Fax:971-771-8638
Practice Address - Street 1:1010 W RALPH M HALL PKWY STE 101
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6656
Practice Address - Country:US
Practice Address - Phone:972-771-9500
Practice Address - Fax:971-771-8638
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX217011223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics