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General NPI Number Information
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NPI Number | 1760815047
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Entity Type | Organization
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Legal Business Name | RHOADS ORTHODONTIC SPECIALIST
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Dates
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Enumeration Date | 08/09/2013
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Last Update Date | 08/09/2013
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Provider Practice Location Address
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Address Line | 132 GRAHAM PARK DR SUITE 300
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City | CRANBERRY TWP
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State | PA
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Zip | 16066-8330
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Country | US
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Telephone | 724-742-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 132 GRAHAM PARK DR SUITE 300
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City | CRANBERRY TWP
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State | PA
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Zip | 16066-8330
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Country | US
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Telephone | 724-742-2300
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Fax |
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. STEPHANIE RHOADS
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Credential | DMD, MBE, MS
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Telephone | 724-742-2300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS038322
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License Number State | PA
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