Individual
DR. LYLY E RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
400 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3250
(203) 503-3254
Mailing address
400 COLUMBUS AVE, NEW HAVEN, CT 06519-1233
(203) 503-3250
(203) 503-3254
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10362
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235893
—
CT
Enumeration date
06/05/2008
Last updated
01/25/2012
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