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General NPI Number Information
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NPI Number | 1588717557
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Entity Type | Organization
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Legal Business Name | GREGORY S ROTOLE DDS PA
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Dates
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Enumeration Date | 01/20/2007
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Last Update Date | 01/23/2013
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Provider Practice Location Address
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Address Line | 2750 STICKNEY POINT RD SUITE 102
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City | SARASOTA
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State | FL
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Zip | 34231-6017
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Country | US
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Telephone | 941-922-0111
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Fax | 941-921-6531
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Provider Business Mailing Address
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Address Line | 2750 STICKNEY POINT RD SUITE 102
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City | SARASOTA
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State | FL
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Zip | 34231-6017
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Country | US
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Telephone | 941-922-0111
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Fax | 941-921-6531
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GREGORY STEPHEN ROTOLE
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Credential | DDS
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Telephone | 941-922-0111
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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 | DN0014656
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License Number State | FL
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