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General NPI Number Information
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NPI Number | 1538529086
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Entity Type | Organization
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Legal Business Name | BONNIE J ROTHWELL DMD PA
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Dates
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Enumeration Date | 02/26/2016
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Last Update Date | 03/05/2016
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Provider Practice Location Address
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Address Line | 11 HOSPITAL CENTER CMNS SUITE 200
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City | HILTON HEAD ISLAND
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State | SC
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Zip | 29926-2844
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Country | US
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Telephone | 843-342-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 11 HOSPITAL CENTER CMNS SUITE 200
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City | HILTON HEAD ISLAND
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State | SC
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Zip | 29926-2844
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Country | US
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Telephone | 843-342-6900
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. BONNIE ROTHWELL
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Credential |
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Telephone | 843-342-6900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | SC4160
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 8695
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | SC3442
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License Number State | SC
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