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General NPI Number Information
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NPI Number | 1710811807
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Entity Type | Organization
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Legal Business Name | SUMTER VALUE DENTAL PLLC
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 410 E BELT AVE
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City | BUSHNELL
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State | FL
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Zip | 33513-5208
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Country | US
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Telephone | 352-569-4962
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Fax |
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Provider Business Mailing Address
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Address Line | 410 E BELT AVE
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City | BUSHNELL
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State | FL
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Zip | 33513-5208
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Country | US
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Telephone | 352-569-4962
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CARLOS RODRIGUEZ
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Credential | DDS
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Telephone | 305-733-2600
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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 |
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License Number State |
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