Provider Demographics
NPI:1548332562
Name:ROTTER, MARIA PAZ (DMD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:PAZ
Last Name:ROTTER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9725 FLOWER ST
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-5803
Mailing Address - Country:US
Mailing Address - Phone:562-867-6196
Mailing Address - Fax:
Practice Address - Street 1:9725 FLOWER ST
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-5803
Practice Address - Country:US
Practice Address - Phone:562-867-6196
Practice Address - Fax:562-866-6057
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA473161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice