Individual
JUAN RODRIGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 N STONEWALL AVE, OKLAHOMA CITY, OK 73117-1214
(405) 271-2189
Mailing address
301 N WALKER AVE, OKLAHOMA CITY, OK 73102-1816
(405) 474-2554
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
VP2
OK
Other
Enumeration date
05/13/2014
Last updated
05/13/2014
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