Individual
SAUL RODRIGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
510 GRISWOLD ST, GLENDALE, CA 91205
(562) 347-9109
Mailing address
510 GRISWOLD ST, GLENDALE, CA 91205
(562) 347-9109
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
53502
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RDA 53502
DENTAL PROVIDER
CA
Enumeration date
11/20/2013
Last updated
11/20/2013
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