Organization
MICHAEL K. ROLLERT, DDS, LLC
Active
Organization
MICHAEL K. ROLLERT, DDS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL KENT ROLLERT DDS (OWNER)
(303) 503-5039
Entity
Organization
Contact information
Practice address
2372 S HUMBOLDT ST, DENVER, CO 80210-5113
(303) 503-5039
Mailing address
2372 S HUMBOLDT ST, DENVER, CO 80210-5113
(303) 503-5039
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
7699
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB1865
MEDICARE PTAN
—
Enumeration date
04/13/2011
Last updated
04/13/2011
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