Provider Demographics
NPI:1700965431
Name:RICK RODEN DDS INC
Entity Type:Organization
Organization Name:RICK RODEN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:J
Authorized Official - Last Name:RODEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:806-364-2213
Mailing Address - Street 1:129 W 5TH
Mailing Address - Street 2:
Mailing Address - City:HEREFORD
Mailing Address - State:TX
Mailing Address - Zip Code:79045
Mailing Address - Country:US
Mailing Address - Phone:806-364-2213
Mailing Address - Fax:806-364-1091
Practice Address - Street 1:129 W 5TH
Practice Address - Street 2:
Practice Address - City:HEREFORD
Practice Address - State:TX
Practice Address - Zip Code:79045
Practice Address - Country:US
Practice Address - Phone:806-364-2213
Practice Address - Fax:803-364-2213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX156641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty