# DR. KEITH STEVEN ROTTMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1912063025
- **Gender:** Man
- **Credential:** DDS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 019018808 | IL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 2901013501 | MI | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 30017878 | OH | — |

## Other

- **Enumeration date:** 01/01/2007
- **Last updated:** 12/04/2008