Individual
DR. KENNETH SHERMAN ROLL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
130 N FRONT ST, SUITE #8, KINGSTON, NY 12401-3741
(845) 338-8812
(845) 338-9086
Mailing address
130 N FRONT ST, SUITE #8, KINGSTON, NY 12401-3741
(845) 338-8812
(845) 338-9086
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
033037
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00636728
—
NY
Enumeration date
06/12/2006
Last updated
06/09/2010
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