| Rodeo Dental and Orthodontics | |
|
1141 Us Business 77 Suite G San Benito TX 78586-4376 | |
| (956) 361-3377 | |
| (817) 928-1681 |
| Full Name | Rodeo Dental and Orthodontics |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1141 Us Business 77, San Benito, Texas |
| Authorized Official Name and Position | Raffy Kouyoumdjian (OWNER) |
| Authorized Official Contact | 8175298151 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rodeo Dental and Orthodontics 100 E. 15th St. Suite 520 Fort Worth TX 76102-6566 Ph: (817) 529-8151 | Rodeo Dental and Orthodontics 1141 Us Business 77 Suite G San Benito TX 78586-4376 Ph: (956) 361-3377 |
| NPI Number | 1528350782 |
|---|---|
| Provider Enumeration Date | 05/06/2011 |
| Last Update Date | 10/26/2022 |
| Certification Date | 10/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528350782 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | () | Secondary |
| 1223G0001X | Dentist - General Practice | () | Primary |
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