Individual
KELLY ANN ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1515 PORTAGE ST NW, SUITE I, NORTH CANTON, OH 44720-2290
(330) 494-0646
(330) 494-9181
Mailing address
7077 PEBBLESTONE AVE NW, NORTH CANTON, OH 44720-6679
(330) 433-9070
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20709
OH
Other
Enumeration date
08/11/2006
Last updated
07/08/2007
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