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General NPI Number Information
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NPI Number | 1023111358
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Entity Type | Individual
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Provider Name | BENTON CHARLES ROTHFIELD DDS
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Gender | Male
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 6805 PEMBROKE RD
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City | PEMBROKE PINES
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State | FL
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Zip | 33023-2620
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Country | US
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Telephone | 954-989-6950
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Fax | 954-989-6962
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Provider Business Mailing Address
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Address Line | 1155 BRICKELL BAY DR PH304
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City | MIAMI
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State | FL
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Zip | 33131-3243
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Country | US
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Telephone | 305-379-0934
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Fax | 305-579-9125
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3839
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License Number State | GA
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