MEDICARE: DR. LOUIS FRANK ROSE D.D.S., M.D.

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
1	1223P0300X	Periodontics	DS016816L	PA

General Provider Information

NPI Number	:	1427062512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS FRANK ROSE D.D.S., M.D.

Provider Business Mailing Address
First Line	:	100 S BROAD ST
Second Line	:	2020 LAND TITLE BUILDING
City	:	PHILADELPHIA
State	:	PA
Zip	:	19110-1023
Country	:	US
Telephone Number	:	215-563-7688
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 S BROAD ST
Second Line	:	2020 LAND TITLE BUILDING
City	:	PHILADELPHIA
State	:	PA
Zip	:	19110-1023
Country	:	US
Telephone Number	:	215-563-7688
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	07/08/2007

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