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General NPI Number Information
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NPI Number | 1467663294
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Entity Type | Individual
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Provider Name | ROSOLINO VINCENT SCLAFANI DDS,MD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7815 E JEFFERSON AVE SUITE 2B
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City | DETROIT
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State | MI
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Zip | 48214-3704
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Country | US
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Telephone | 313-499-4775
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Fax | 313-499-4908
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Provider Business Mailing Address
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Address Line | 37251 WILLOW LN
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48036-3667
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Country | US
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Telephone | 586-362-4544
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 2901019257
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License Number State | MI
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