Juan Antonio Rodriguez Jr.
Dental Hygienist in Ft Eisenhower, GA. Individual provider (NPI-1).
NPI number1619708526
StatusActive
Last updated in NPPESAug 12, 2024
Details
- NPI
- 1619708526
- Entity type
- Individual (NPI-1)
- Name
- Juan Antonio Rodriguez Jr.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 12, 2024
- Certification date
- Aug 7, 2024
- Last updated
- Aug 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 124Q00000X | Dental Hygienist | – | – | Yes |
Practice location
Bldg 25501 Brainard AveFt Eisenhower, GA 30905
Phone 706-787-7050
Mailing address
Bldg 25501 Brainard AveFt Eisenhower, GA 30905
Phone 706-787-7050
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