Provider Demographics
NPI:1174762777
Name:RODRIGUEZ-RIOS, EDWIN DANIEL (DMD)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:DANIEL
Last Name:RODRIGUEZ-RIOS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:45 CALLE ANDALUCIA
Mailing Address - Street 2:STE. 201
Mailing Address - City:MAYAGUEZ
Mailing Address - State:PR
Mailing Address - Zip Code:00680-8201
Mailing Address - Country:US
Mailing Address - Phone:787-265-5701
Mailing Address - Fax:787-256-5794
Practice Address - Street 1:45 CALLE ANDALUCIA
Practice Address - Street 2:STE. 201
Practice Address - City:MAYAGUEZ
Practice Address - State:PR
Practice Address - Zip Code:00680-8201
Practice Address - Country:US
Practice Address - Phone:787-265-5701
Practice Address - Fax:787-256-5794
Is Sole Proprietor?:No
Enumeration Date:2009-02-05
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR28011223P0700X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist