DR. BRUCE E ROTTER D.M.D.
NPI 1043207046
Dentist - Oral and Maxillofacial Surgery in Glen Carbon, IL

Active since October 04, 2005
132 CRYSTAL GATE LN, GLEN CARBON, IL 62034(618) 288-0962 Get Directions Write a Review

NPPES record last updated: April 17, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Bruce E Rotter D.m.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BRUCE E ROTTER D.M.D. (NPI 1043207046) is an individual oral and maxillofacial surgery provider in Glen Carbon, Illinois, licensed in Illinois (021-001642) and active in the NPI registry since October 2005.

NPPES Registry Identity

NPI1043207046
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. BRUCE E ROTTERCredential: D.M.D.
Location Address132 CRYSTAL GATE LNGlen Carbon, IL 62034-1141
Mailing Address132 Crystal Gate LnGlen Carbon, IL 62034-1141 · (618) 288-0962
Sole ProprietorNo
Enumeration DateOctober 4, 2005
Last NPPES UpdateApril 17, 2013
NPI 1043207046 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License Licensed in IL · 021-001642
Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Also ListedDentistTaxonomy 122300000X · License 019-018159 (IL)
132 CRYSTAL GATE LN, Glen Carbon, IL 62034

Other Identifiers 5

Other1420102IL · United Concordia Prov Id
Medicare UPINT95304ID
Medicare PINL92149IL
Medicare PIN190010592IL
Other480442IL · Healthlink Ins Prov Id

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bruce Rotter's NPI number?

The NPI number for Bruce Rotter is 1043207046. It was assigned to this individual provider in the NPPES registry on October 4, 2005.

Where is Bruce Rotter located?

Bruce Rotter practices at 132 Crystal Gate Ln, Glen Carbon, IL 62034. The listed phone number is (618) 288-0962.

What is Bruce Rotter's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

When was this NPI record last updated?

The NPPES record for Bruce Rotter was last updated on April 17, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.