Provider Demographics
NPI:1548221211
Name:ROTHSCHILD, DAVID (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:ROTHSCHILD
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 1:77 HOSPITAL AVE
Mailing Address - Street 2:STE 212
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247
Mailing Address - Country:US
Mailing Address - Phone:413-664-4100
Mailing Address - Fax:413-663-7220
Practice Address - Street 1:77 HOSPITAL AVE
Practice Address - Street 2:STE 212
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247
Practice Address - Country:US
Practice Address - Phone:413-664-4100
Practice Address - Fax:413-663-7220
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12496204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01005210Medicaid
VT0002457Medicaid
MA0256854Medicaid
VT0002457Medicaid
MA0256854Medicaid
VTVT2457Medicare PIN