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General NPI Number Information
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NPI Number | 1912161886
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Entity Type | Individual
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Provider Name | JILL ROSELLINI OMBRELLO DDS
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Gender | Female
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 04/15/2009
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Provider Practice Location Address
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Address Line | 189 HISTORIC TOWN SQ
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City | LANCASTER
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State | TX
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Zip | 75146-3226
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Country | US
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Telephone | 214-642-7962
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Fax |
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Provider Business Mailing Address
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Address Line | 189 HISTORIC TOWN SQ
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City | LANCASTER
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State | TX
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Zip | 75146-3226
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Country | US
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Telephone | 214-642-7962
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Fax | 972-239-1038
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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 | 24086
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License Number State | TX
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