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General NPI Number Information
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NPI Number | 1083062004
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Entity Type | Individual
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Provider Name | ANGELA J RHODES D.D.S
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Gender | Female
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Dates
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Enumeration Date | 05/31/2016
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 2311 N 9TH ST STE 102
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City | BROKEN ARROW
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State | OK
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Zip | 74012-2887
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Country | US
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Telephone | 918-994-2100
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Fax | 918-994-2101
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Provider Business Mailing Address
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Address Line | 2311 N 9TH ST STE 102
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City | BROKEN ARROW
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State | OK
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Zip | 74012-2887
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Country | US
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Telephone | 918-994-2100
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Fax | 918-994-2101
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6828
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License Number State | OK
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