Healthcare Provider Details

I. General information

NPI: 1730257460
Provider Name (Legal Business Name): ROSANNA MARQUEZ DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1920 E. HIGHWAY 54 STE 410
RESEARCH TRIANGLE PARK NC
27713
US

IV. Provider business mailing address

416 COPPERLINE DR
CHAPEL HILL NC
27516-4480
US

V. Phone/Fax

Practice location:
  • Phone: 919-544-8106
  • Fax: 919-544-8536
Mailing address:
  • Phone: 919-960-0119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number8006
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: