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NPI Code Detail

MEDICARE: PRACTICE TRANSITIONS PC

MEDICARE: PRACTICE TRANSITIONS PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist07401IA

General Provider Information

NPI Number : 1205131919
Entity Type Code : Organization
Provider Name (Legal Business Name) : PRACTICE TRANSITIONS PC
Provider Business Mailing Address
First Line : 1615 32ND ST NE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-4072
Country : US
Telephone Number : 319-294-2323
Fax Number : 319-395-6715
Provider Business Practice Location Address
First Line : 3605 CENTER POINT RD NE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52402-5571
Country : US
Telephone Number : 319-294-2323
Fax Number : 319-395-6715
Authorized Official
Title or Position : CO-OWNER
Name : DR. ROBERT CHARLES RODRIGUEZ
Credential : DDS
Telephone Number : 319-294-2323
Provider Enumeration Date : 01/12/2011
Last Update Date : 01/12/2011

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Directions to “PRACTICE TRANSITIONS PC ” Practice Location

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