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Individual

DR. ANGEL EMMANUEL RODRIGUEZ PENA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS, MSD

Contact information

Practice address
8938 S BROADWAY AVE STE 480, TYLER, TX 75703-5733
(918) 801-8124
Mailing address
11950 ERWIN ST APT 337, NORTH HOLLYWOOD, CA 91606

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
104508
CA
1223P0300X
Periodontics
34440
TX

Other

Enumeration date
08/22/2018
Last updated
02/23/2022
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