Healthcare Provider Details

I. General information

NPI: 1285824631
Provider Name (Legal Business Name): PATRICIA A ROSMAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 07/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 W FIRST AVE
ODESSA WA
99159-0429
US

IV. Provider business mailing address

PO BOX 429
ODESSA WA
99159-0429
US

V. Phone/Fax

Practice location:
  • Phone: 509-982-2605
  • Fax: 509-982-9951
Mailing address:
  • Phone: 509-982-2605
  • Fax: 509-982-9951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5874
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: