Provider Demographics
NPI:1083805196
Name:RHODES, ROCHELLE A (DMD)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:A
Last Name:RHODES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 MAIN ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02081-2997
Mailing Address - Country:US
Mailing Address - Phone:508-668-1531
Mailing Address - Fax:508-668-0419
Practice Address - Street 1:841 MAIN ST
Practice Address - Street 2:SUITE 3
Practice Address - City:WALPOLE
Practice Address - State:MA
Practice Address - Zip Code:02081-2997
Practice Address - Country:US
Practice Address - Phone:508-668-1531
Practice Address - Fax:508-668-0419
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA198031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice