Individual
DR. JACK S ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
133 E 58TH ST, SUITE 308, NEW YORK, NY 10022-1236
(212) 838-2011
(212) 838-0486
Mailing address
133 E 58TH ST, SUITE 308, NEW YORK, NY 10022-1236
(212) 838-2011
(212) 838-0486
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
35973
NY
Other
Enumeration date
08/22/2007
Last updated
08/22/2007
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