| NPI | 1609387612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RACHAEL LOUISE RODRIGUEZ Dds, Member 479-250-1516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2018-05-15 |