Provider Demographics
NPI:1396916425
Name:RITA BOBB-ROLLINS, DDS, P.C.
Entity type:Organization
Organization Name:RITA BOBB-ROLLINS, DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACI DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:CRONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-521-9370
Mailing Address - Street 1:367 MEMORIAL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-4007
Mailing Address - Country:US
Mailing Address - Phone:413-263-6616
Mailing Address - Fax:
Practice Address - Street 1:367 MEMORIAL AVE
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-4007
Practice Address - Country:US
Practice Address - Phone:413-263-6616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22025122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty