Rodriguez, Juan C

Rodriguez, Juan C is an individual health care provider with primary practice located at 24760 Hospital Drive , Red Lake MN 56671-0497. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Rodriguez, Juan C can be contacted via phone (218) 679-3912.

Contact Information

Primary practice address
24760 Hospital Drive Red Lake MN 56671-0497
Phone: (218) 679-3912
Fax: (218) 679-0810
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X D02194 Puerto Rico

Profile Details

NPI number 1821135377
LBN Legal business name Rodriguez, Juan C
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2007
Last updated Feb 19th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821135377 NPPES
South Dakota MEDICAID 5549010

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