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General NPI Number Information
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NPI Number | 1215806617
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Entity Type | Individual
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Provider Name | ELIZABETH MARTHA ROSS DMD
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Gender | Female
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 1234 N SANTA FE AVE
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City | VISTA
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State | CA
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Zip | 92083-3206
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Country | US
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Telephone | 760-732-5878
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Fax |
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Provider Business Mailing Address
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Address Line | 1234 N SANTA FE AVE
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City | VISTA
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State | CA
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Zip | 92083-3206
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Country | US
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Telephone | 618-340-3684
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 108399
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License Number State | CA
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