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General NPI Number Information
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NPI Number | 1063956415
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Entity Type | Organization
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Legal Business Name | STEVEN J ROLLINS DMD PC
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Dates
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Enumeration Date | 12/05/2016
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Last Update Date | 12/05/2016
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Provider Practice Location Address
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Address Line | 6100 DIXIE HWY SUITE A
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City | CLARKSTON
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State | MI
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Zip | 48346-3496
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Country | US
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Telephone | 248-623-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 4983 TIMBER LAKE TRL
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City | CLARKSTON
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State | MI
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Zip | 48346-3978
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Country | US
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Telephone | 248-623-4600
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Fax | 248-623-6365
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Authorized Official
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Title or Position | OWNER
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Name | DR. STEVEN J ROLLINS
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Credential | DMD
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Telephone | 847-722-7663
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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 |
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License Number State |
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