Healthcare Provider Details

I. General information

NPI: 1134229099
Provider Name (Legal Business Name): CRAIG E ROTHFUSZ DDS PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 W CALEDONIA AVE
HILLSBORO ND
58045-0176
US

IV. Provider business mailing address

7 W CALEDONIA AVE
HILLSBORO ND
58045-0176
US

V. Phone/Fax

Practice location:
  • Phone: 701-636-4244
  • Fax: 701-636-5370
Mailing address:
  • Phone: 701-636-4244
  • Fax: 701-636-5370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1750
License Number StateND

VIII. Authorized Official

Name: DR. CRAIG E ROTHFUSZ
Title or Position: OWNER DENTIST
Credential: DDS
Phone: 701-636-4244