Provider Demographics
NPI:1770172991
Name:ROCKDALE DENTAL ASSOCIATES PLLC
Entity type:Organization
Organization Name:ROCKDALE DENTAL ASSOCIATES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARVALHO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-992-4608
Mailing Address - Street 1:499 ROCKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02740-1460
Mailing Address - Country:US
Mailing Address - Phone:508-992-4608
Mailing Address - Fax:
Practice Address - Street 1:499 ROCKDALE AVE
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-1460
Practice Address - Country:US
Practice Address - Phone:508-992-4608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental