Provider Demographics
NPI:1386658508
Name:ROTHLEDER, DAVID BARRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BARRY
Last Name:ROTHLEDER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 BONIFANT RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905-5910
Mailing Address - Country:US
Mailing Address - Phone:301-384-3277
Mailing Address - Fax:301-384-5881
Practice Address - Street 1:315 BONIFANT RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20905-5910
Practice Address - Country:US
Practice Address - Phone:301-384-3277
Practice Address - Fax:301-384-5881
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0053131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice