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General NPI Number Information
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NPI Number | 1467435073
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Entity Type | Individual
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Provider Name | RAYMOND G RODRIGUEZ DDS
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Gender | Male
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Dates
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Enumeration Date | 11/29/2005
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 696 WALNUT AVE STE 1
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City | GREENFIELD
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State | CA
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Zip | 93927-4928
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Country | US
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Telephone | 831-674-5501
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Fax |
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Provider Business Mailing Address
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Address Line | 608 E BORONDA RD STE B
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City | SALINAS
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State | CA
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Zip | 93906-3129
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Country | US
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Telephone | 831-443-3524
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Fax |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 36695
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License Number State | CA
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