Provider Demographics
NPI:1730133075
Name:RICHARD L. ROTHSTEIN, DMD,PA
Entity Type:Organization
Organization Name:RICHARD L. ROTHSTEIN, DMD,PA
Other - Org Name:ORTHODONTICS ONLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROTHSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:305-598-3384
Mailing Address - Street 1:9485 SW 72ND ST
Mailing Address - Street 2:SUITE A-100
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173-3242
Mailing Address - Country:US
Mailing Address - Phone:305-598-3384
Mailing Address - Fax:305-598-3675
Practice Address - Street 1:9485 SW 72ND ST
Practice Address - Street 2:SUITE A-100
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3214
Practice Address - Country:US
Practice Address - Phone:305-598-3384
Practice Address - Fax:305-598-3675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL47711223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty