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General NPI Number Information
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NPI Number | 1942531231
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Entity Type | Individual
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Provider Name | CAROLINA RODRIGUEZ DDS
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Gender | Female
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Dates
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Enumeration Date | 01/26/2010
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 516 HUMBOLDT AVE
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City | SAINT PAUL
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State | MN
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Zip | 55107-4014
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Country | US
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Telephone | 651-280-2262
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Fax |
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Provider Business Mailing Address
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Address Line | 5603 DONEGAL DR
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City | SHOREVIEW
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State | MN
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Zip | 55126-4720
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Country | US
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Telephone | 651-399-1230
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Fax | 651-204-0639
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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 | R454
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License Number State | MN
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