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General NPI Number Information
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NPI Number | 1821135377
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Entity Type | Individual
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Provider Name | JUAN C RODRIGUEZ D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 6010 W AMARILLO BLVD
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City | AMARILLO
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State | TX
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Zip | 79106-1990
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Country | US
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Telephone | 806-355-9703
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Fax |
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Provider Business Mailing Address
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Address Line | 6010 W AMARILLO BLVD
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City | AMARILLO
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State | TX
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Zip | 79106-1990
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Country | US
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Telephone | 806-355-9703
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Fax |
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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 | D02194
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2194
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License Number State | PR
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