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General NPI Number Information
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NPI Number | 1245462753
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Entity Type | Organization
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Legal Business Name | MELISSA V. ROZAS, DDS DENTISTRY FOR INFANTS, CHILDREN AND TEENS, P.A
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Dates
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Enumeration Date | 08/17/2009
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Last Update Date | 08/17/2009
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Provider Practice Location Address
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Address Line | 632 E SANDY LAKE RD
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City | COPPELL
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State | TX
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Zip | 75019-3019
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Country | US
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Telephone | 972-393-9779
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Fax | 972-393-9775
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Provider Business Mailing Address
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Address Line | 632 E SANDY LAKE RD
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City | COPPELL
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State | TX
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Zip | 75019-3019
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Country | US
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Telephone | 972-393-9779
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Fax | 972-393-9775
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Authorized Official
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Title or Position | OWNER / DENTIST
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Name | MELISSA ROZAS
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Credential | D.D.S.
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Telephone | 972-393-9779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 18278
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License Number State | TX
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