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General NPI Number Information
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NPI Number | 1821247776
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Entity Type | Individual
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Provider Name | JONATHAN P ROSCOE DMD
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Gender | Male
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 1494A S ARLINGTON AVE
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City | AKRON
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State | OH
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Zip | 44306-3832
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Country | US
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Telephone | 330-479-3225
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Fax | 330-478-4781
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Provider Business Mailing Address
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Address Line | 1494A S ARLINGTON AVE
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City | AKRON
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State | OH
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Zip | 44306-3832
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Country | US
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Telephone | 330-479-3225
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Fax | 330-478-4781
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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 | 30022801
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License Number State | OH
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