Individual
FAUSTO RODELA-RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
1415 TOWN SQUARE LN, FARIBAULT, MN 55021-6088
(507) 323-8100
(833) 974-2090
Mailing address
1415 TOWN SQUARE LN, FARIBAULT, MN 55021-6088
(507) 323-8100
(833) 974-2090
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
H11333
RDH LICENSE
MN
Enumeration date
06/15/2022
Last updated
06/15/2022
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