Provider Demographics
NPI:1215206248
Name:RODRIGUEZ, HECTOR CARLOS (DDS)
Entity Type:Individual
Prefix:
First Name:HECTOR
Middle Name:CARLOS
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 WINDCREST DR
Mailing Address - Street 2:SUITE100 SMILE BRANDS,INC
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-3087
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6501 WINDCREST DR
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3075
Practice Address - Country:US
Practice Address - Phone:813-925-1916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-20
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20517122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist