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General NPI Number Information
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NPI Number | 1538308309
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Entity Type | Organization
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Legal Business Name | DONALD R. ROZEMA DDS, PC
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 02/18/2009
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Provider Practice Location Address
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Address Line | 300 WEST WIEUCA ROAD NE BUILDING 2 SUITE 210
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City | ATLANTA
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State | GA
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Zip | 30342-3352
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Country | US
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Telephone | 404-252-4220
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Fax | 404-252-4013
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Provider Business Mailing Address
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Address Line | 300 WEST WIEUCA ROAD NE BUILDING 2 SUITE 210
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City | ATLANTA
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State | GA
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Zip | 30342-3352
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Country | US
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Telephone | 404-252-4220
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Fax | 404-252-4013
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Authorized Official
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Title or Position | OWNER/ CEO
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Name | DR. DONALD RAY ROZEMA
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Credential | D.D.S.
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Telephone | 404-252-4220
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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 | DNES000136
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License Number State | GA
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