Provider Demographics
NPI:1548222722
Name:RODO, NICHOLAS (DDS)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:
Last Name:RODO
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 1:2799 SOUTHWESTERN BLVD
Mailing Address - Street 2:SMILE DESIGN DENTISTRY
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127
Mailing Address - Country:US
Mailing Address - Phone:716-675-2900
Mailing Address - Fax:716-675-1262
Practice Address - Street 1:2799 SOUTHWESTERN BLVD
Practice Address - Street 2:SMILE DESIGN DENTISTRY
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14217
Practice Address - Country:US
Practice Address - Phone:716-675-2900
Practice Address - Fax:716-675-1262
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039147122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist