Individual
DR. JOHN P ROTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14465 METCALF AVE, OVERLAND PARK, KS 66223-2990
(913) 553-2492
(913) 553-2493
Mailing address
14465 METCALF AVE, OVERLAND PARK, KS 66223-2990
(913) 553-2492
(913) 553-2493
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
60313
KS
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
60313
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201141800A
—
KS
Enumeration date
08/13/2007
Last updated
01/25/2017
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