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General NPI Number Information
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NPI Number | 1952570707
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Entity Type | Organization
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Legal Business Name | EXETER COSMETIC DENTISTRY
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 6 HEARTHSTONE CT SUITE304
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City | READING
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State | PA
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Zip | 19606-3065
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Country | US
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Telephone | 610-370-5955
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Fax | 610-370-5957
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Provider Business Mailing Address
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Address Line | 1288 VALLEY FORGE RD SUITE 70
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City | PHOENIXVILLE
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State | PA
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Zip | 19460-2687
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Country | US
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Telephone | 610-935-7509
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Fax | 610-935-0625
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD ROUZER
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Credential | DDS
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Telephone | 610-935-7509
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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 | DS024944L
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License Number State | PA
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