Provider Demographics
NPI:1043654908
Name:MICHAEL & DAVID ROTHAN DDS, INC
Entity Type:Organization
Organization Name:MICHAEL & DAVID ROTHAN DDS, INC
Other - Org Name:TWIN DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:ROTHAN
Authorized Official - Suffix:
Authorized Official - Credentials:DENTIST
Authorized Official - Phone:513-825-6111
Mailing Address - Street 1:11430 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45231-6104
Mailing Address - Country:US
Mailing Address - Phone:513-825-6111
Mailing Address - Fax:513-825-5947
Practice Address - Street 1:11430 HAMILTON AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45231-6104
Practice Address - Country:US
Practice Address - Phone:513-825-6111
Practice Address - Fax:513-825-5947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300182771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty