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Organization

ROTH & NORTON FAMILY DENTISTRY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMY ROTH (OFFICE MANAGER)
(641) 472-3044
Entity
Organization

Contact information

Practice address
205 N B ST, FAIRFIELD, IA 52556-2944
(641) 472-3044
Mailing address
205 N B ST, FAIRFIELD, IA 52556-2944
(641) 472-3044

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0184630
IA
05
1114206513
IA
05
1881123750
IA
Enumeration date
01/09/2020
Last updated
01/09/2020
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