Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 12496 | MA |
NPI | 1548221211 |
---|---|
Provider Name | Dr. David Rothschild |
First Address | North Adams, MA 01247 |
Second Address | North Adams, MA 01247 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2006 |
Last Update Date | 12/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0002457 | (05) | VT |
01005210 | (05) | NY |
0256854 | (05) | MA |
T25333 | (02) |