Provider Demographics
NPI:1194976290
Name:DAVID M. ROSHKIND, DMD, P.A.
Entity type:Organization
Organization Name:DAVID M. ROSHKIND, DMD, P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:ROSHKIND
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:352-372-1966
Mailing Address - Street 1:4965 NW 8TH AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4530
Mailing Address - Country:US
Mailing Address - Phone:352-372-1966
Mailing Address - Fax:352-372-1937
Practice Address - Street 1:4965 NW 8TH AVE
Practice Address - Street 2:SUITE B
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-4530
Practice Address - Country:US
Practice Address - Phone:352-372-1966
Practice Address - Fax:352-372-1937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty