| Rodeo Dental | |
|
1300 South Cage Blvd. Ste. K Pharr TX 78577 | |
| (817) 624-6677 | |
| Not Available |
| Full Name | Rodeo Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1300 South Cage Blvd., Pharr, Texas |
| Authorized Official Name and Position | Raffy Kouyoumdjian (OWNER) |
| Authorized Official Contact | 8186539799 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rodeo Dental 1300 South Cage Blvd. Ste. K Pharr TX 78577 Ph: (817) 624-6677 | Rodeo Dental 1300 South Cage Blvd. Ste. K Pharr TX 78577 Ph: (817) 624-6677 |
| NPI Number | 1396029781 |
|---|---|
| Provider Enumeration Date | 10/04/2011 |
| Last Update Date | 10/04/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396029781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 23066 (Texas) | Secondary |
| 1223G0001X | Dentist - General Practice | 24133 (Texas) | Primary |
| 1223P0221X | Dentist - Pediatric Dentistry | 21527 (Texas) | Secondary |
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