Provider Demographics
NPI:1811070527
Name:RODNEY, PATRICIA CAROLINE (DDS)
Entity type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:CAROLINE
Last Name:RODNEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W 5TH ST
Mailing Address - Street 2:SUITE 553
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-1668
Mailing Address - Country:US
Mailing Address - Phone:734-945-7805
Mailing Address - Fax:
Practice Address - Street 1:2711 RANDOLPH RD
Practice Address - Street 2:SUITE 205
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28207-2034
Practice Address - Country:US
Practice Address - Phone:704-377-2503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC82831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice