Healthcare Provider Details

I. General information

NPI: 1801809512
Provider Name (Legal Business Name): RODNEY A FLOYD DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 GENERALS HIGHWAY
CROWNSVILLE MD
21032
US

IV. Provider business mailing address

1017 GENERALS HIGHWAY
CROWNSVILLE MD
21032
US

V. Phone/Fax

Practice location:
  • Phone: 410-923-2586
  • Fax: 410-729-0545
Mailing address:
  • Phone: 410-923-2586
  • Fax: 410-729-0545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5334
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: