Provider Demographics
NPI:1881894863
Name:HODAPP, MICHAEL HARVEY (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HARVEY
Last Name:HODAPP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:MICHAEL
Other - Middle Name:H
Other - Last Name:HODAPP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:903 BAY AREA BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2647
Mailing Address - Country:US
Mailing Address - Phone:281-488-2200
Mailing Address - Fax:
Practice Address - Street 1:903 BAY AREA BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2647
Practice Address - Country:US
Practice Address - Phone:281-488-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16574122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist