Provider Demographics
NPI:1295890770
Name:ROWBOTTOM, JOSEPH PAUL (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PAUL
Last Name:ROWBOTTOM
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 1:119 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-2112
Mailing Address - Country:US
Mailing Address - Phone:585-343-7127
Mailing Address - Fax:585-343-7175
Practice Address - Street 1:119 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-2112
Practice Address - Country:US
Practice Address - Phone:585-343-7127
Practice Address - Fax:585-343-7175
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0265951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7225JROtherBLUE CROSS BLUE SHIELD
NY00590583Medicaid