Provider Demographics
NPI:1316129786
Name:ROLF, ERIN NICHOLE (DMD)
Entity type:Individual
Prefix:DR
First Name:ERIN
Middle Name:NICHOLE
Last Name:ROLF
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:PO BOX 706
Mailing Address - Street 2:HWY 77/75
Mailing Address - City:WINNEBAGO
Mailing Address - State:NE
Mailing Address - Zip Code:68071-0706
Mailing Address - Country:US
Mailing Address - Phone:402-878-2465
Mailing Address - Fax:402-878-2535
Practice Address - Street 1:HWY 77/75
Practice Address - Street 2:
Practice Address - City:WINNEBAGO
Practice Address - State:NE
Practice Address - Zip Code:68071-0706
Practice Address - Country:US
Practice Address - Phone:402-878-2465
Practice Address - Fax:402-878-2535
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE67221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice