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General NPI Number Information
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NPI Number | 1124004098
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Entity Type | Individual
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Provider Name | ANGELA MARIA ROSS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 710 HART LN
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City | NASHVILLE
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State | TN
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Zip | 37216-2627
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Country | US
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Telephone | 615-650-7060
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Fax | 615-262-6139
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Provider Business Mailing Address
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Address Line | 173 BRIAN CIR
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City | ANTIOCH
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State | TN
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Zip | 37013-4342
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Country | US
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Telephone | 615-834-2611
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Fax | 615-837-1837
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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 | DS000007201
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License Number State | TN
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