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NPI Code Detail

MEDICARE: DR. PHILIP PAUL ROTHERMEL D.D.S.

MEDICARE:  DR. PHILIP PAUL ROTHERMEL  D.D.S.
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
11223G0001XGeneral Practice Dentistry7869NC

General Provider Information

NPI Number : 1184738098
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PHILIP PAUL ROTHERMEL D.D.S.
Provider Business Mailing Address
First Line : 141 CLUB POINTE DR
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27104-3663
Country : US
Telephone Number : 336-201-3057
Fax Number :
Provider Business Practice Location Address
First Line : 131 MILLER ST
Second Line :
City : WINSTON SALEM
State : NC
Zip : 27103-2508
Country : US
Telephone Number : 336-716-2183
Fax Number : 336-716-3997
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2006
Last Update Date : 07/08/2007

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Directions to “ DR. PHILIP PAUL ROTHERMEL D.D.S.” Practice Location

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