Individual
EDISON RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
345 E 24TH ST, NEW YORK, NY 10010-4020
(212) 998-9800
Mailing address
345 E 24TH ST, NEW YORK, NY 10010-4020
(212) 998-9800
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
41595
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/30/2023
Last updated
07/07/2025
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