MEDICARE: DR. STEVEN CHARLES RHODES DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	20800	OH

General Provider Information

NPI Number	:	1073724043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN CHARLES RHODES DDS

Provider Business Mailing Address
First Line	:	3014 CANAL RD
Second Line	:
City	:	WOOSTER
State	:	OH
Zip	:	44691-7929
Country	:	US
Telephone Number	:	330-262-2845
Fax Number	:	330-264-5622

Provider Business Practice Location Address
First Line	:	909 DOVER RD
Second Line	:
City	:	WOOSTER
State	:	OH
Zip	:	44691-4105
Country	:	US
Telephone Number	:	330-264-5522
Fax Number	:	330-264-5622

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	07/08/2007

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