Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 11061 | MT |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 44270 | CO |
NPI | 1518936533 |
---|---|
Provider Name | Dr. Brennan Thomas Dodson |
First Address | Bozeman, MT 59715-8811 |
Second Address | Bozeman, MT 59715-8811 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 05/07/2017 |