Calvin Chase Bodman, DDS
Dentist in Los Angeles, CA. Individual provider (NPI-1).
NPI number1124836770
StatusActive
Last updated in NPPESDec 27, 2024
Details
- NPI
- 1124836770
- Entity type
- Individual (NPI-1)
- Name
- Calvin Chase Bodman
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 27, 2024
- Certification date
- Dec 27, 2024
- Last updated
- Dec 27, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 111114 | CA | Yes |
Practice location
4900 Whittier BlvdLos Angeles, CA 90022-3115
Phone 323-780-0009
Mailing address
538 Sonoma StSan Marcos, CA 92078-4238
Phone 760-978-7085
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