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NPI Code Detail

MEDICARE: DR. ROSEMARY ELAINE ENGLE D.D.S.

MEDICARE: DR. ROSEMARY ELAINE ENGLE D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDE00009457WA

General Provider Information

NPI Number : 1003020215
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROSEMARY ELAINE ENGLE D.D.S.
Provider Business Mailing Address
First Line : 531 SE KAMILCHE SHORES RD
Second Line :
City : SHELTON
State : WA
Zip : 98584-7742
Country : US
Telephone Number : 360-426-9003
Fax Number : 360-426-9013
Provider Business Practice Location Address
First Line : 4818B SHE NAH NUM DR SE
Second Line :
City : OLYMPIA
State : WA
Zip : 98513-9105
Country : US
Telephone Number : 360-459-5312
Fax Number : 360-407-0860
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 07/08/2007

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