Individual
DR. PHILIP ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
574 EAST 200TH STREET, EUCLID, OH 44119-1570
(216) 481-6142
Mailing address
574 EAST 200TH STREET, EUCLID, OH 44119-1570
(216) 481-6142
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13810
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0209189
—
OH
Enumeration date
03/19/2007
Last updated
07/08/2007
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