Provider Demographics
NPI:1043334931
Name:ROSENE, NORMAN LEELAND (DDS)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:LEELAND
Last Name:ROSENE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 LUPIN AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-0933
Mailing Address - Country:US
Mailing Address - Phone:530-324-4300
Mailing Address - Fax:
Practice Address - Street 1:952 LUPIN AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95973-0933
Practice Address - Country:US
Practice Address - Phone:530-324-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33511122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist