Provider Demographics
NPI:1730786526
Name:KATHLEEN ROLFES DMD, INC.
Entity type:Organization
Organization Name:KATHLEEN ROLFES DMD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OF CORPORATION
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROLFES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:661-201-6037
Mailing Address - Street 1:6439 MANDY LN
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-9763
Mailing Address - Country:US
Mailing Address - Phone:661-201-6037
Mailing Address - Fax:
Practice Address - Street 1:1405 COMMERCIAL WAY STE 140
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-0626
Practice Address - Country:US
Practice Address - Phone:661-201-6037
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-05
Last Update Date:2021-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental