MEDICARE: PAMELA S ROTWEIN DDS

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	261QD0000X	Dental Clinic/Center	5487	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598281099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAMELA S ROTWEIN DDS

Provider Business Mailing Address
First Line	:	695 S COLORADO BLVD STE 265
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80246-8012
Country	:	US
Telephone Number	:	303-377-0699
Fax Number	:

Provider Business Practice Location Address
First Line	:	695 S COLORADO BLVD STE 265
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80246-8012
Country	:	US
Telephone Number	:	303-377-0699
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	PAMELA ROTWEIN
Credential	:	DDS
Telephone Number	:	303-377-0699

Provider Enumeration Date	:	08/16/2017
Last Update Date	:	08/16/2017

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