Healthcare Provider Details

I. General information

NPI: 1811930845
Provider Name (Legal Business Name): DAVID ROSANIA DMD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 09/08/2022
Certification Date: 09/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

185 COTTAGE ST STE 2
PORTSMOUTH NH
03801-4108
US

IV. Provider business mailing address

185 COTTAGE ST STE 2
PORTSMOUTH NH
03801-4108
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number1737
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: