Provider Demographics
NPI:1972656767
Name:ROLLOFSON, DONALD PAUL (DMD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:PAUL
Last Name:ROLLOFSON
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Gender:M
Credentials:DMD
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Mailing Address - Street 1:9727 ELK GROVE FLORIN RD
Mailing Address - Street 2:280
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-2264
Mailing Address - Country:US
Mailing Address - Phone:916-685-2164
Mailing Address - Fax:916-685-2167
Practice Address - Street 1:9727 ELK GROVE FLORIN RD
Practice Address - Street 2:280
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-2264
Practice Address - Country:US
Practice Address - Phone:916-685-2164
Practice Address - Fax:916-685-2167
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CA301511223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics