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Organization
RODEO DENTAL SAN BENITO, PLLC
Active
Organization
RODEO DENTAL SAN BENITO, PLLC
Active
Other names
Rodeo Dental and Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFFY KOUYOUMDJIAN DMD (OWNER)
(817) 529-8151
Entity
Organization
Contact information
Practice address
1141 US BUSINESS 77, SUITE G, SAN BENITO, TX 78586-4376
(956) 361-3377
(817) 928-1681
Mailing address
100 E. 15TH ST., SUITE 520, FORT WORTH, TX 76102-6566
(817) 529-8151
(817) 928-1681
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/06/2011
Last updated
10/26/2022
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