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General NPI Number Information
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NPI Number | 1144496225
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Entity Type | Organization
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Legal Business Name | TIMOTHY C ROTHROCK, DDS, PA
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Dates
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Enumeration Date | 05/07/2008
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 1308 S PLEASANT ST
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City | SPRINGDALE
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State | AR
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Zip | 72764-6223
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Country | US
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Telephone | 479-751-5071
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Fax | 479-751-7990
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Provider Business Mailing Address
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Address Line | 1308 S PLEASANT ST
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City | SPRINGDALE
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State | AR
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Zip | 72764-6223
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Country | US
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Telephone | 479-751-5071
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Fax | 479-751-7990
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TIMOTHY CHARLES ROTHROCK
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Credential | DDS
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Telephone | 479-751-5071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 2869
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License Number State | AR
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