Provider Demographics
NPI:1508809724
Name:RHODES, ANGIE S (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANGIE
Middle Name:S
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 1:685A N.C. HWY. 33 EAST
Mailing Address - Street 2:
Mailing Address - City:CHOCOWINITY
Mailing Address - State:NC
Mailing Address - Zip Code:27817
Mailing Address - Country:US
Mailing Address - Phone:252-974-2300
Mailing Address - Fax:252-974-2100
Practice Address - Street 1:685A N.C. HWY. 33 EAST
Practice Address - Street 2:
Practice Address - City:CHOCOWINITY
Practice Address - State:NC
Practice Address - Zip Code:27817
Practice Address - Country:US
Practice Address - Phone:252-974-2300
Practice Address - Fax:252-974-2100
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC70301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice