Justin Lee Roth, DDS

NPI #1104827930 in Colorado Springs, Colorado

Provider Information

NPI Number: 1104827930
Entity Type: Individual
Name: Justin Lee Roth, DDS
Gender: Not Specified
Sole Proprietor: Not Answered
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Aug 2, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 5929 CONSTITUTION AVE
City: Colorado Springs
State: Colorado
ZIP Code: 80915-1211
Phone: (719) 638-1986

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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