Provider Demographics
NPI:1043266588
Name:ROSSETTI & MYERS DDS, LLC
Entity Type:Organization
Organization Name:ROSSETTI & MYERS DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:ROSSETTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-747-0090
Mailing Address - Street 1:2613 N PARHAM RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4650
Mailing Address - Country:US
Mailing Address - Phone:804-747-0090
Mailing Address - Fax:804-270-9461
Practice Address - Street 1:2613 N PARHAM RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23294-4650
Practice Address - Country:US
Practice Address - Phone:804-747-0090
Practice Address - Fax:804-270-9461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010076311223G0001X
VA04010074011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty