Provider Demographics
NPI:1588676720
Name:ROTHENBERG, LITA JANE (DMD)
Entity Type:Individual
Prefix:DR
First Name:LITA
Middle Name:JANE
Last Name:ROTHENBERG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 EAST FIRST AVE
Mailing Address - Street 2:
Mailing Address - City:TARCNTUM
Mailing Address - State:PA
Mailing Address - Zip Code:15084-1765
Mailing Address - Country:US
Mailing Address - Phone:724-226-8777
Mailing Address - Fax:724-226-8799
Practice Address - Street 1:215 EAST FIRST AVE
Practice Address - Street 2:
Practice Address - City:TARCNTUM
Practice Address - State:PA
Practice Address - Zip Code:15084-1765
Practice Address - Country:US
Practice Address - Phone:724-226-8777
Practice Address - Fax:724-226-8799
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020206L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist