Rodriguez-Lichtenberg, Kevin Manuel

Rodriguez-Lichtenberg, Kevin Manuel is an individual health care provider with primary practice located at 12165 Elm St , Princess Anne MD 21853-1358. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is his primary health care specialty. Rodriguez-Lichtenberg, Kevin Manuel can be contacted via phone (410) 749-1015.

Contact Information

Primary practice address
12165 Elm St Princess Anne MD 21853-1358
Phone: (410) 749-1015
Fax: (410) 749-0654
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 0401417104 Virginia
Dental Providers / Pediatric Dentistry 1223P0221X 17358 Maryland

Profile Details

NPI number 1790318152
LBN Legal business name Rodriguez-Lichtenberg, Kevin Manuel
Credentials DDS, MPH
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2020
Last updated Mar 21st, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790318152 NPPES
Maryland MEDICAID 119591300

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