Provider Demographics
NPI:1861565236
Name:ROTHER, DONALD JOSEPH JR (DDS)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JOSEPH
Last Name:ROTHER
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3261 ROUTE 100
Mailing Address - Street 2:
Mailing Address - City:MACUNGIE
Mailing Address - State:PA
Mailing Address - Zip Code:18062
Mailing Address - Country:US
Mailing Address - Phone:610-966-3399
Mailing Address - Fax:
Practice Address - Street 1:3261 ROUTE 100
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062
Practice Address - Country:US
Practice Address - Phone:610-966-3399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS21761L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice