Provider Demographics
NPI:1699327973
Name:RODRIGUEZ ROJAS, NATHALIA F (DMD)
Entity type:Individual
Prefix:
First Name:NATHALIA
Middle Name:F
Last Name:RODRIGUEZ ROJAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 SHINE LN
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-1445
Mailing Address - Country:US
Mailing Address - Phone:267-357-2020
Mailing Address - Fax:
Practice Address - Street 1:2202 S W S YOUNG DR STE 102
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-5318
Practice Address - Country:US
Practice Address - Phone:267-357-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35489122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist