Provider Demographics
NPI:1104947415
Name:HODGES, DAIN J (DDS)
Entity type:Individual
Prefix:DR
First Name:DAIN
Middle Name:J
Last Name:HODGES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3335 HICKORY BROOK LN
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-1140
Mailing Address - Country:US
Mailing Address - Phone:281-358-6659
Mailing Address - Fax:
Practice Address - Street 1:6516 JOHN FREEMAN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3402
Practice Address - Country:US
Practice Address - Phone:713-500-4210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX138911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice