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Individual

RODOLFO DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.S.

Contact information

Practice address
32750 GRAND RIVER AVE, FARMINGTON, MI 48336-3133
(248) 476-6200
(248) 476-4642
Mailing address
5050 SCHAEFER RD, DEARBORN, MI 48126-3249
(313) 582-8150
(313) 582-6015

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901019304
MI

Other

Enumeration date
08/06/2008
Last updated
08/06/2008
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