Individual
DANIEL RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
660 S 200 E STE 250, SALT LAKE CITY, UT 84111-3846
(801) 359-2256
Mailing address
10911 S 1055 W, SOUTH JORDAN, UT 84095-8214
(702) 884-1493
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6159362-9922
UT
1223D0001X
Public Health Dentistry
6159362-9922
UT
1223G0001X
General Practice Dentistry
6159362-9922
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/20/2018
Last updated
09/12/2020
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