Individual
PROF. DALE L RODRIGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
58 STATE STREET, AUGUSTA, ME 04330
(207) 623-5099
(207) 623-7124
Mailing address
58 STATE STREET, AUGUSTA, ME 04330
(207) 623-5099
(207) 623-7124
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
690T ADVANCED
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114510000
—
ME
Enumeration date
08/23/2006
Last updated
07/14/2008
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