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General NPI Number Information
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NPI Number | 1083780084
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Entity Type | Organization
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Legal Business Name | DORA E RODRIGUEZ DMD PA
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 9449 SHERIDAN STREET SUITE B
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City | COOPER CITY
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State | FL
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Zip | 33024
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Country | US
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Telephone | 954-431-3025
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Fax | 954-431-3201
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Provider Business Mailing Address
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Address Line | 9449 SHERIDAN STREET SUITE B
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City | COOPER CITY
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State | FL
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Zip | 33024
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Country | US
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Telephone | 954-431-3025
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Fax | 954-431-3201
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. DORA E RODRIGUEZ
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Credential | DMD
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Telephone | 954-431-3025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN16833
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License Number State | FL
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