Provider Demographics
NPI:1659723898
Name:RODRIGUEZ, JOSEPH (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2313 THONOTOSASSA RD
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-1460
Mailing Address - Country:US
Mailing Address - Phone:813-704-6986
Mailing Address - Fax:813-704-6986
Practice Address - Street 1:2313 THONOTOSASSA RD
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-1460
Practice Address - Country:US
Practice Address - Phone:813-704-6986
Practice Address - Fax:813-704-6986
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN220831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice