Provider Demographics
NPI:1962646422
Name:RODRIGUEZ KOVACS, ALEJANDRO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEJANDRO
Middle Name:
Last Name:RODRIGUEZ KOVACS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5100 EDEN AVE
Mailing Address - Street 2:STE 209
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55436-2337
Mailing Address - Country:US
Mailing Address - Phone:952-929-0641
Mailing Address - Fax:952-929-1802
Practice Address - Street 1:5100 EDEN AVE
Practice Address - Street 2:STE 209
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55436-2337
Practice Address - Country:US
Practice Address - Phone:952-929-0641
Practice Address - Fax:952-929-1802
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND126411223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics