Provider Demographics
NPI:1124138797
Name:ROTROFF, NANCY (DDS)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:ROTROFF
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2480 EAST COMMERCIAL BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308
Mailing Address - Country:US
Mailing Address - Phone:954-928-1666
Mailing Address - Fax:954-928-1895
Practice Address - Street 1:2480 EAST COMMERCIAL BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308
Practice Address - Country:US
Practice Address - Phone:954-928-1666
Practice Address - Fax:954-928-1895
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN10611122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN10611OtherDENTAL LICENSE
FLAR2258944OtherDEA