Healthcare Provider Details

I. General information

NPI: 1811381544
Provider Name (Legal Business Name): AMY E. ROSANIA, DMD, MSCD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2015
Last Update Date: 03/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 GREENALND ROAD SUITE B-7
PORTSMOUTH NH
03801
US

IV. Provider business mailing address

875 GREENALND ROAD SUITE B-7
PORTSMOUTH NH
03801
US

V. Phone/Fax

Practice location:
  • Phone: 603-294-0110
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State

VIII. Authorized Official

Name: DAVID ROSANIA
Title or Position: PARTNER
Credential:
Phone: 603-767-0158