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Individual

ROBERTA RODRIGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
15136 ST HWY 75, PENASCO, NM 87553
(575) 587-2809
(575) 587-2605
Mailing address
PO BOX 158, ESPANOLA, NM 87532-0158
(505) 753-7218
(505) 747-7396

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary

Other

Enumeration date
09/18/2018
Last updated
09/18/2018
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