Provider Demographics
NPI:1063286144
Name:CHRISTY K. ROLLOFSON, DDS, INC
Entity type:Organization
Organization Name:CHRISTY K. ROLLOFSON, DDS, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOULADI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-685-2105
Mailing Address - Street 1:9727 ELK GROVE FLORIN RD STE 270
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-2290
Mailing Address - Country:US
Mailing Address - Phone:916-685-2105
Mailing Address - Fax:
Practice Address - Street 1:9727 ELK GROVE FLORIN RD STE 270
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-2290
Practice Address - Country:US
Practice Address - Phone:916-685-2105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-09
Last Update Date:2024-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental