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NPI Code Detail

MEDICARE: DR. RICHARD A ROSEN D.D.S.

MEDICARE:  DR. RICHARD A ROSEN  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 Dentistry15557MA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
115557OTHERMASTATE PRACTICE LICENSE #

General Provider Information

NPI Number : 1679621387
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD A ROSEN D.D.S.
Provider Business Mailing Address
First Line : 631A VFW PKWY
Second Line :
City : CHESTNUT HILL
State : MA
Zip : 02467-3656
Country : US
Telephone Number : 617-327-3500
Fax Number : 617-325-3887
Provider Business Practice Location Address
First Line : 631A VFW PKWY
Second Line :
City : CHESTNUT HILL
State : MA
Zip : 02467-3656
Country : US
Telephone Number : 617-327-3500
Fax Number : 617-325-3887
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2007
Last Update Date : 07/08/2007

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Directions to “ DR. RICHARD A ROSEN D.D.S.” Practice Location

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