Individual
DR. RICHARD J. ROOTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
140 E LAKE ST, LAKE MILLS, WI 53551-1659
(920) 648-8254
(920) 648-3655
Mailing address
140 E LAKE ST, LAKE MILLS, WI 53551-1659
(920) 648-8254
(920) 648-3655
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5001379WI
WI
Other
Enumeration date
11/02/2005
Last updated
07/08/2007
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