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General NPI Number Information
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NPI Number | 1588078273
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Entity Type | Organization
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Legal Business Name | P. HIRAM RODRIGUEZ, DDS, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 06/20/2014
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Last Update Date | 01/10/2017
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Provider Practice Location Address
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Address Line | 600 COFFEE RD STE Q
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City | BAKERSFIELD
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State | CA
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Zip | 93309-1264
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Country | US
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Telephone | 661-323-4400
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Fax | 661-323-4401
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Provider Business Mailing Address
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Address Line | 600 COFFEE RD STE Q
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City | BAKERSFIELD
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State | CA
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Zip | 93309-1264
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Country | US
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Telephone | 661-323-4400
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Fax | 661-323-4401
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Authorized Official
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Title or Position | OWNER
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Name | PEDRO HIRAM RODRIGUEZ
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Credential | DDS
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Telephone | 661-323-4400
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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 | 31113
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License Number State | CA
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