Provider Demographics
NPI:1215517487
Name:DODSON, DENISE NICOLE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:NICOLE
Last Name:DODSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:DENISE
Other - Middle Name:NICOLE
Other - Last Name:CHARBONEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1700 NORTON RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-1512
Mailing Address - Country:US
Mailing Address - Phone:330-650-4093
Mailing Address - Fax:
Practice Address - Street 1:1700 NORTON RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-1512
Practice Address - Country:US
Practice Address - Phone:330-650-4093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH03232685183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist