Tejada, Rodolfo

Tejada, Rodolfo is an individual health care provider with primary practice located at 2435 S Volusia Ave Ste D2 , Orange City FL 32763-7643. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Tejada, Rodolfo can be contacted via phone (386) 878-4395.

Contact Information

Primary practice address
2435 S Volusia Ave Ste D2 Orange City FL 32763-7643
Phone: (386) 878-4395
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DN20826 Florida

Profile Details

NPI number 1427345057
LBN Legal business name Tejada, Rodolfo
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 4th, 2011
Last updated Jul 1st, 2019 - about 7 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 1427345057 NPPES
Florida MEDICAID 023632900

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