DR. Brandon J Roth, DDS

NPI #1679733612 in Appleton, Wisconsin

Provider Information

NPI Number: 1679733612
Entity Type: Individual
Name: DR. Brandon J Roth, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jun 12, 2008
Last Updated: Jan 21, 2011

Practice Location

Address: 3030 N BALLARD RD
City: Appleton
State: Wisconsin
ZIP Code: 54911-8707
Phone: (920) 954-8085

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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