Individual
JANNA C ROUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1205 BOLL WEEVIL CIR, ENTERPRISE, AL 36330-1377
(334) 347-9564
Mailing address
552 OLD SMIZER MILL RD, FENTON, MO 63026-3538
(636) 326-7633
(636) 600-1229
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2018018448
MO
1223G0001X
General Practice Dentistry
2018018448
MO
1223G0001X
General Practice Dentistry
D.007264-C
AL
1223G0001X
General Practice Dentistry
DN123263
GA
Other
Enumeration date
06/27/2018
Last updated
02/25/2025
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