MEDICARE: DR. ROBERT M. ROSSON DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D12491	TX

General Provider Information

NPI Number	:	1023036209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT M. ROSSON DDS

Provider Business Mailing Address
First Line	:	3110 TRAWOOD DR
Second Line	:	SUITE D
City	:	EL PASO
State	:	TX
Zip	:	79936-4394
Country	:	US
Telephone Number	:	915-855-1000
Fax Number	:	915-855-6600

Provider Business Practice Location Address
First Line	:	3110 TRAWOOD DR
Second Line	:	SUITE D
City	:	EL PASO
State	:	TX
Zip	:	79936-4394
Country	:	US
Telephone Number	:	915-855-1000
Fax Number	:	915-855-6600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/19/2007

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