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General NPI Number Information
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NPI Number | 1538603444
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Entity Type | Organization
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Legal Business Name | JOSEPH L. RODRIGUEZ DDS AND ASSOCIATES PLLC
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Dates
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Enumeration Date | 12/12/2016
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Last Update Date | 12/12/2016
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Provider Practice Location Address
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Address Line | 1301 MAIN ST SUITE 9
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City | SALMON
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State | ID
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Zip | 83467-4451
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Country | US
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Telephone | 804-513-9434
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 MAIN ST SUITE 9
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City | SALMON
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State | ID
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Zip | 83467-4451
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSEPH L RODRIGUEZ
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Credential | DDS
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Telephone | 804-513-9434
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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 | 9646
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License Number State | NC
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