Organization
DONALD P. ROTEN, DDS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD PERRIN ROTEN SR. D.D.S. (PRESIDENT)
(662) 837-4664
Entity
Organization
Contact information
Practice address
307 UNION ST, RIPLEY, MS 38663-1718
(662) 837-4664
(662) 837-1501
Mailing address
307 UNION ST, RIPLEY, MS 38663-1718
(662) 837-4664
(662) 837-1501
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
MS1279-67
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00060081
—
MS
Enumeration date
03/01/2007
Last updated
08/26/2008
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