Healthcare Provider Details

I. General information

NPI: 1922028331
Provider Name (Legal Business Name): DAVID S. ROSS DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 11/19/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4949 BATTERY LN
BETHESDA MD
20814-4942
US

IV. Provider business mailing address

4949 BATTERY LN
BETHESDA MD
20814-4942
US

V. Phone/Fax

Practice location:
  • Phone: 301-656-9565
  • Fax: 301-907-9546
Mailing address:
  • Phone: 301-656-9565
  • Fax: 301-907-9546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number06549
License Number StateMD

VIII. Authorized Official

Name: DR. DAVID S ROSS
Title or Position: PRESIDENT
Credential: DDS
Phone: 301-656-9565