Provider Demographics
NPI:1922422195
Name:RODRIGUEZ-PAZ, MONICA DENISE (DMD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:DENISE
Last Name:RODRIGUEZ-PAZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21711 FRONTENAC CT
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-7476
Mailing Address - Country:US
Mailing Address - Phone:561-715-0481
Mailing Address - Fax:
Practice Address - Street 1:21711 FRONTENAC CT
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-7476
Practice Address - Country:US
Practice Address - Phone:561-715-0481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-09
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX316161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice