Individual
YNDIRA STACEY RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
36101 GOODWIN DR, LOCUST GROVE, VA 22508-2029
(560) 680-0923
Mailing address
442 W 160TH ST APT 1D, NEW YORK, NY 10032-6340
(646) 643-5664
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401417714
VA
Other
Enumeration date
11/18/2021
Last updated
11/18/2021
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