Rotter, Bruce E

Rotter, Bruce E is an individual health care provider with primary practice located at 132 Crystal Gate Ln , Glen Carbon IL 62034-1141. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Rotter, Bruce E can be contacted via phone (618) 288-0962.

Contact Information

Primary practice address
132 Crystal Gate Ln Glen Carbon IL 62034-1141
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 019-018159 Illinois
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 021-001642 Illinois

Profile Details

NPI number 1043207046
LBN Legal business name Rotter, Bruce E
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2005
Last updated Apr 17th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043207046 NPPES
Illinois Other 480442 HEALTHLINK INS PROV ID
Illinois Other 1420102 HEALTHLINK INS PROV ID

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