Provider Demographics
NPI:1417066267
Name:RODRIGUEZ, YOLANDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:
Last Name:RODRIGUEZ
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:N3 AVE LOMAS VERDES
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00956-3102
Mailing Address - Country:US
Mailing Address - Phone:787-798-3587
Mailing Address - Fax:787-798-3587
Practice Address - Street 1:N3 AVE LOMAS VERDES
Practice Address - Street 2:
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00956-3102
Practice Address - Country:US
Practice Address - Phone:787-798-3587
Practice Address - Fax:787-798-3587
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PRD01969122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist