Provider Demographics
NPI:1003000654
Name:RHODES, CAROLINE MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:MARIE
Last Name:RHODES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20821 US HWY 281 SUITE 310
Mailing Address - Street 2:STONE OAK MODERN DENTISTRY
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258
Mailing Address - Country:US
Mailing Address - Phone:210-494-4488
Mailing Address - Fax:
Practice Address - Street 1:20821 US HWY 281 SUITE 310
Practice Address - Street 2:STONE OAK MODERN DENTISTRY
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258
Practice Address - Country:US
Practice Address - Phone:210-494-4488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA552191223G0001X
TX262991223G0001X
MS3531-091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice