Healthcare Provider Details

I. General information

NPI: 1467317388
Provider Name (Legal Business Name): ROSEMANN DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

299 THERESA ST
CUBA MO
65453-1604
US

IV. Provider business mailing address

299 THERESA ST
CUBA MO
65453-1604
US

V. Phone/Fax

Practice location:
  • Phone: 573-261-2415
  • Fax: 573-885-5900
Mailing address:
  • Phone: 573-261-2415
  • Fax: 573-885-5900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CAITLIN LEEANN ROSEMANN
Title or Position: DENTIST/OWNER
Credential: DMD, MPH
Phone: 573-261-2415