Provider Demographics
NPI:1164621983
Name:ROTHE, ANNIE L (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:L
Last Name:ROTHE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2088
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:AK
Mailing Address - Zip Code:99664-2088
Mailing Address - Country:US
Mailing Address - Phone:907-224-4926
Mailing Address - Fax:907-224-4933
Practice Address - Street 1:201 3RD AVE.
Practice Address - Street 2:SUITE 115
Practice Address - City:SEWARD
Practice Address - State:AK
Practice Address - Zip Code:99664
Practice Address - Country:US
Practice Address - Phone:907-224-4926
Practice Address - Fax:907-224-4933
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1236122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist