Roth, Roger J.

Roth, Roger J. is an individual health care provider with primary practice located at 1801 N 3Rd St , Coeur D Alene ID 83814-3400. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Roth, Roger J. can be contacted via phone (208) 667-1578.

Contact Information

Primary practice address
1801 N 3Rd St Coeur D Alene ID 83814-3400
Fax: (208) 765-9116
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DD1443 Idaho

Profile Details

NPI number 1700882164
LBN Legal business name Roth, Roger J.
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated Jul 8th, 2007 - about 19 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 1700882164 NPPES
Washington Other 7170 WDS
Washington Other 4084 WDS

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