Provider Demographics
NPI:1972729382
Name:ROTILIE, JAMES A (DDS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:A
Last Name:ROTILIE
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 1:4222 STATE ROUTE 43
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-6918
Mailing Address - Country:US
Mailing Address - Phone:330-678-3228
Mailing Address - Fax:330-678-4826
Practice Address - Street 1:4222 STATE ROUTE 43
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-6918
Practice Address - Country:US
Practice Address - Phone:330-678-3228
Practice Address - Fax:330-678-4826
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30016599122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist