Provider Demographics
NPI:1134770365
Name:ROTONDI, OLIVIA ANNE (DMD)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:ANNE
Last Name:ROTONDI
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 1:2001 MARLTON PIKE E
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1200
Mailing Address - Country:US
Mailing Address - Phone:215-435-3252
Mailing Address - Fax:
Practice Address - Street 1:2001 MARLTON PIKE E
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1200
Practice Address - Country:US
Practice Address - Phone:856-424-5145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-29
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02776100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist