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General NPI Number Information
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NPI Number | 1710220447
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Entity Type | Organization
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Legal Business Name | RODLIN JEROME DDS PA
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Dates
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Enumeration Date | 04/01/2013
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Last Update Date | 04/01/2013
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Provider Practice Location Address
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Address Line | 20823 NW 2ND AVE
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-2103
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Country | US
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Telephone | 305-704-8977
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Fax | 305-704-8984
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Provider Business Mailing Address
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Address Line | 20823 NW 2ND AVE
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City | MIAMI GARDENS
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State | FL
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Zip | 33169-2103
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Country | US
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Telephone | 305-704-8977
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RODLIN JEROME
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Credential | DDS
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Telephone | 305-704-8977
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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 | DN19632
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License Number State | FL
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