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General NPI Number Information
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NPI Number | 1699822213
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Entity Type | Individual
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Provider Name | SHOLI ABRAHAM ROTBLATT DDS
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Gender | Male
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4301 FLORENCE AVE
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City | BELL
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State | CA
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Zip | 90201-3525
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Country | US
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Telephone | 323-771-4053
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11000
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City | WESTMINSTER
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State | CA
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Zip | 92685-1000
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Country | US
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Telephone | 714-724-6564
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Fax | 714-625-4999
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 25622
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License Number State | CA
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