Provider Demographics
NPI:1952508079
Name:RODRIGUES DENTAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:RODRIGUES DENTAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUES
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:508-235-0488
Mailing Address - Street 1:1355 OLD FALL RIVER RD
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1160
Mailing Address - Country:US
Mailing Address - Phone:508-674-0395
Mailing Address - Fax:
Practice Address - Street 1:1535 S MAIN ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02724-2605
Practice Address - Country:US
Practice Address - Phone:508-235-0488
Practice Address - Fax:508-235-0444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA144961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9792660Medicaid