Provider Demographics
NPI:1225073463
Name:PALOUTZIAN, RODNEY DALE (DDS)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:DALE
Last Name:PALOUTZIAN
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 1:212 E MERCED ST
Mailing Address - Street 2:
Mailing Address - City:FOWLER
Mailing Address - State:CA
Mailing Address - Zip Code:93625-2313
Mailing Address - Country:US
Mailing Address - Phone:559-834-5313
Mailing Address - Fax:
Practice Address - Street 1:212 E MERCED ST
Practice Address - Street 2:
Practice Address - City:FOWLER
Practice Address - State:CA
Practice Address - Zip Code:93625-2313
Practice Address - Country:US
Practice Address - Phone:559-834-5313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18492122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist