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General NPI Number Information
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NPI Number | 1194960138
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Entity Type | Individual
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Provider Name | CAMILLE ROSE D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 12/04/2008
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Last Update Date | 03/31/2017
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Provider Practice Location Address
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Address Line | 6646 OLD WINTER GARDEN RD
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City | ORLANDO
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State | FL
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Zip | 32835-1231
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Country | US
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Telephone | 407-292-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 6646 OLD WINTER GARDEN RD
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City | ORLANDO
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State | FL
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Zip | 32835-1231
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Country | US
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Telephone | 407-292-6400
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 20005
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 1000020
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 12380
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License Number State | MD
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