Provider Demographics
NPI:1760815047
Name:RHOADS ORTHODONTIC SPECIALIST
Entity Type:Organization
Organization Name:RHOADS ORTHODONTIC SPECIALIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RHOADS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MBE, MS
Authorized Official - Phone:724-742-2300
Mailing Address - Street 1:132 GRAHAM PARK DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-8330
Mailing Address - Country:US
Mailing Address - Phone:724-742-2300
Mailing Address - Fax:
Practice Address - Street 1:132 GRAHAM PARK DR
Practice Address - Street 2:SUITE 300
Practice Address - City:CRANBERRY TWP
Practice Address - State:PA
Practice Address - Zip Code:16066-8330
Practice Address - Country:US
Practice Address - Phone:724-742-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-09
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0383221223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty