Organization
MAIRA M RODRIGUEZ DMD PC
Active
Other names
Broad Street Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAIRA M RODRIGUEZ DMD (PRESIDENT)
(734) 426-8292
Entity
Organization
Contact information
Practice address
3288 BROAD ST, DEXTER, MI 48130-1153
(734) 426-8292
(734) 426-9059
Mailing address
3288 BROAD ST, DEXTER, MI 48130-1153
(734) 426-8292
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901018189
MI
Other
Enumeration date
05/04/2008
Last updated
05/04/2008
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