Provider Demographics
NPI:1790328508
Name:RODRIGUES DENTAL GROUP
Entity Type:Organization
Organization Name:RODRIGUES DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:RODRIGUES
Authorized Official - Last Name:ESPINOLA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-672-8984
Mailing Address - Street 1:1395 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02723-1718
Mailing Address - Country:US
Mailing Address - Phone:508-672-8984
Mailing Address - Fax:508-672-4239
Practice Address - Street 1:1395 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02723-1718
Practice Address - Country:US
Practice Address - Phone:508-672-8984
Practice Address - Fax:508-672-4239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty