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General NPI Number Information
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NPI Number | 1457899775
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Entity Type | Organization
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Legal Business Name | OLIVIA M. RODRIGUES, DDS, PC
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Dates
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Enumeration Date | 02/07/2017
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Last Update Date | 02/07/2017
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Provider Practice Location Address
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Address Line | 7471 WATT AVE STE 107A
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City | NORTH HIGHLANDS
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State | CA
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Zip | 95660-2632
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Country | US
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Telephone | 916-331-1211
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Fax | 916-331-1287
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Provider Business Mailing Address
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Address Line | 7909 WALERGA RD #112 PMB 209
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City | ANTELOPE
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State | CA
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Zip | 95843-5727
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Country | US
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Telephone | 916-331-1211
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Fax | 916-331-1287
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. OLIVIA M. RODRIGUES
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Credential | DDS
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Telephone | 916-331-1211
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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 | 30865
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License Number State | CA
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