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NPI Code Detail

MEDICARE: DR. ROBERT CARMEN ROSE D.M.D.

MEDICARE: DR. ROBERT CARMEN ROSE D.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
11223G0001XGeneral Practice DentistryDS021361LPA

General Provider Information

NPI Number : 1922001718
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT CARMEN ROSE D.M.D.
Provider Business Mailing Address
First Line : 995 OLD EAGLE SCHOOL RD
Second Line : SUITE 305
City : WAYNE
State : PA
Zip : 19087-1709
Country : US
Telephone Number : 610-687-0990
Fax Number :
Provider Business Practice Location Address
First Line : 995 OLD EAGLE SCHOOL RD
Second Line : SUITE 305
City : WAYNE
State : PA
Zip : 19087-1709
Country : US
Telephone Number : 610-687-0990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 02/09/2016

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