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General NPI Number Information
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NPI Number | 1417968686
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Entity Type | Organization
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Legal Business Name | DALE A ROLANDO DMD AND SUE E ROLANDO DMD PA
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4396 LAKE UNDERHILL RD
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City | ORLANDO
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State | FL
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Zip | 32803
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Country | US
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Telephone | 407-898-7401
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Fax | 407-898-7030
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Provider Business Mailing Address
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Address Line | 4396 LAKE UNDERHILL RD
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City | ORLANDO
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State | FL
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Zip | 32803
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Country | US
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Telephone | 407-898-7401
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Fax | 407-898-7030
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Authorized Official
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Title or Position | VICE PRES
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Name | DR. SUE ELLEN ROLANDO
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Credential | DMD
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Telephone | 407-898-7401
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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 | DN10144
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN10143
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License Number State | FL
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