Basic Information
| Provider Information | |||||||||
| NPI: | 1528354677 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DODDS | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | RITA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | DMD | ||||||||
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| Mailing Information | |||||||||
| Address1: | JOINT BASE LEWIS MCCHORD DENTAC | ||||||||
| Address2: | BLDG. 9900, 2ND FLOOR, LINCOLN STREET | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984310001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539684029 | ||||||||
| FaxNumber: | 2539685919 | ||||||||
| Practice Location | |||||||||
| Address1: | JOINT BASE LEWIS MCCHORD DENTAC | ||||||||
| Address2: | BLDG. 9900, 2ND FLOOR, LINCOLN STREET | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984310001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539684029 | ||||||||
| FaxNumber: | 2539685919 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2011 | ||||||||
| LastUpdateDate: | 06/27/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | DE60173343 | WA | Y | Dental Providers | Dentist |
No ID Information.