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General NPI Number Information
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NPI Number | 1083187538
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Entity Type | Individual
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Provider Name | STEPHEN ROTH DDS
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Gender | Male
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Dates
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Enumeration Date | 01/08/2019
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 650 W BALTIMORE ST FL 7
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City | BALTIMORE
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State | MD
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Zip | 21201-1510
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Country | US
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Telephone | 410-706-8345
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Fax |
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Provider Business Mailing Address
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Address Line | 650 W BALTIMORE ST FL 7
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City | BALTIMORE
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State | MD
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Zip | 21201-1510
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Country | US
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Telephone |
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Fax |
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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 | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | 061196
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | LL935
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License Number State | MD
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