Basic Information
| Provider Information | |||||||||
| NPI: | 1003000654 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RHODES | ||||||||
| FirstName: | CAROLINE | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 20821 US HWY 281 SUITE 310 | ||||||||
| Address2: | STONE OAK MODERN DENTISTRY | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104944488 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 20821 US HWY 281 SUITE 310 | ||||||||
| Address2: | STONE OAK MODERN DENTISTRY | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104944488 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2007 | ||||||||
| LastUpdateDate: | 06/10/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 55219 | CA | N | Dental Providers | Dentist | General Practice | 1223G0001X | 26299 | TX | Y | Dental Providers | Dentist | General Practice | 1223G0001X | 3531-09 | MS | N | Dental Providers | Dentist | General Practice |
No ID Information.