Individual
DANIEL H ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1713 VOGT DR, WEST BEND, WI 53095-8516
(262) 334-3070
Mailing address
509 SUMMIT DR, WEST BEND, WI 53095-3853
(262) 334-5249
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
1343
WI
Other
Enumeration date
06/27/2006
Last updated
07/08/2007
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