Individual
DR. MARK DAVID ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
(954) 472-0418
Mailing address
840 MOCKINGBIRD LN, PLANTATION, FL 33324-3406
(954) 472-0418
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6440
FL
Other
Enumeration date
12/05/2006
Last updated
07/08/2007
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