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General NPI Number Information
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NPI Number | 1740371616
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Entity Type | Organization
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Legal Business Name | KYLE ROTH AND ASSOCIATES VI, DDS, PA
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1310 WAYNE MEMORIAL DR STE C
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City | GOLDSBORO
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State | NC
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Zip | 27534-2269
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Country | US
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Telephone | 919-581-0909
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Fax | 919-581-0730
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Provider Business Mailing Address
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Address Line | 1310 WAYNE MEMORIAL DR STE C
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City | GOLDSBORO
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State | NC
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Zip | 27534-2269
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Country | US
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Telephone | 919-581-0909
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Fax | 919-581-0730
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MEGAN PRIDGEN
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Credential |
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Telephone | 919-696-6394
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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 |
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License Number State |
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