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Individual

DR. GARY D ROTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

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
1223G0001X
General Practice Dentistry
Primary
IA06694
IA

Other

Enumeration date
10/23/2006
Last updated
07/08/2007
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