Provider Demographics
NPI:1407569676
Name:JOHN J. ROTHRAUFF, D.D.S., INC.
Entity Type:Organization
Organization Name:JOHN J. ROTHRAUFF, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROTHRAUFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-757-7713
Mailing Address - Street 1:20 E MCKINLEY WAY
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44514-2071
Mailing Address - Country:US
Mailing Address - Phone:330-757-7713
Mailing Address - Fax:
Practice Address - Street 1:20 E MCKINLEY WAY
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44514-2071
Practice Address - Country:US
Practice Address - Phone:330-757-7713
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty