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General NPI Number Information
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NPI Number | 1790930725
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Entity Type | Individual
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Provider Name | PEDRO A RODRIGUEZ D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 680 YOUNGSTOWN-WARREN RD
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City | NILES
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State | OH
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Zip | 44446
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Country | US
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Telephone | 330-989-6550
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Fax | 330-989-6551
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Provider Business Mailing Address
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Address Line | 680 YOUNGSTOWN-WARREN RD
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City | NILES
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State | OH
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Zip | 44446
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Country | US
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Telephone | 330-989-6550
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Fax | 330-989-6551
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 30-022921
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License Number State | OH
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