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General NPI Number Information
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NPI Number | 1003953878
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Entity Type | Individual
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Provider Name | JOHN MARION ROSSI DDS
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Gender | Male
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 504 228TH AVE NE
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City | SAMMAMISH
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State | WA
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Zip | 98074-7226
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Country | US
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Telephone | 425-868-3887
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Fax | 485-868-8339
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Provider Business Mailing Address
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Address Line | 251 EAST LK. SAMM PKWY NE
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City | SAMMAMISH
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State | WA
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Zip | 98074-7226
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Country | US
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Telephone | 425-868-6920
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DE 5315
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License Number State | WA
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