MEDICARE: ROTH & PRESSLEY DDS, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1083892715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROTH & PRESSLEY DDS, PA

Provider Business Mailing Address
First Line	:	3693 NEW BERN AVE
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-1232
Country	:	US
Telephone Number	:	919-345-9511
Fax Number	:

Provider Business Practice Location Address
First Line	:	3693 NEW BERN AVE
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27610-1232
Country	:	US
Telephone Number	:	919-345-9511
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	CHRISTY RASHAWN BALDWIN
Credential	:
Telephone Number	:	919-345-9511

Provider Enumeration Date	:	02/05/2008
Last Update Date	:	02/05/2008

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