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General NPI Number Information
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NPI Number | 1700998853
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Entity Type | Individual
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Provider Name | STEPHEN MICHAEL ROSS D.D.S
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 110 LOCKWOOD AVE
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-5028
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Country | US
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Telephone | 914-632-3132
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Fax | 914-740-0047
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Provider Business Mailing Address
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Address Line | 15 BREVOORT LN
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City | RYE
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State | NY
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Zip | 10580-1003
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Country | US
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Telephone | 914-698-8209
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Fax | 914-698-3825
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 28148
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License Number State | NY
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