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 |