Most Relevant Information
Provider Data
| NPI Number: | 1003362559 |
| Provider Name: | ANGEL RODRIGUEZTAPIA |
| Entity Type: | Individual |
| Taxonomy Code: | 126800000X |
| Specialty: | Dental Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/25/2016 |
| Last Updated: | 08/25/2016 |
Provider Practice Location
962 1ST INFANTRY DIVISION RD
JORDAN DENTAL CLINIC BLDG 2724
FORT KNOX
KY
401215210
Practice Location Phone/Fax
| Phone: | 5026268301 |
| Fax: | 5026268300 |
Provider Mailing Location
398 192ND ARMOR TANK BATTALION RD
USA DENTAC HQS BLDG 1022
FORT KNOX
KY
401215116
Provider Mailing Phone/Fax
| Phone: | 5026246158 |
| Fax: | 5026242966 |