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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