MEDICARE: GREGORY ROSECRANS DDS PC

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	122300000X	Dentist	2901015852	MI

General Provider Information

NPI Number	:	1548392731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREGORY ROSECRANS DDS PC

Provider Business Mailing Address
First Line	:	2107 16TH STREET
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-7607
Country	:	US
Telephone Number	:	989-892-7832
Fax Number	:	989-892-2251

Provider Business Practice Location Address
First Line	:	2107 16TH STREET
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-7607
Country	:	US
Telephone Number	:	989-892-7832
Fax Number	:	989-892-2251

Authorized Official
Title or Position	:	DENTIST PRESIDENT
Name	:	DR. GREGORY ARTHUR ROSECRANS
Credential	:	DDS
Telephone Number	:	989-892-7832

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	08/22/2020

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