LARRY ROTH

CHICAGO, IL
NPI1003211780
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: IL  019.016425)
Enumeration Date2014-10-24
Last Update Date2014-10-24
Business Address
LARRY ROTH
1637 W WABANSIA AVE
CHICAGO, IL 60622-1443
Phone number: 773-486-1286
Mailing Address
LARRY ROTH
1637 W WABANSIA AVE
CHICAGO, IL 60622-1443
Phone number: 773-486-1286
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