Provider Demographics
NPI:1386678282
Name:ROTH & ROBINSON, DDS, PA
Entity Type:Organization
Organization Name:ROTH & ROBINSON, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BALDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-345-9511
Mailing Address - Street 1:6800 DEMOCRACY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-3868
Mailing Address - Country:US
Mailing Address - Phone:704-535-8794
Mailing Address - Fax:704-537-0403
Practice Address - Street 1:6800 DEMOCRACY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212-3868
Practice Address - Country:US
Practice Address - Phone:704-535-8794
Practice Address - Fax:704-537-0403
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC86551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCBG8152338OtherDEA