Provider Demographics
NPI:1053329821
Name:ROZEN, JAN BARRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAN
Middle Name:BARRY
Last Name:ROZEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:50 SALEM ST
Mailing Address - Street 2:BLDG A
Mailing Address - City:LYNNFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01940
Mailing Address - Country:US
Mailing Address - Phone:781-245-8828
Mailing Address - Fax:781-224-1158
Practice Address - Street 1:5 LONGFELLOW PLACE
Practice Address - Street 2:SUITE 205
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-742-3525
Practice Address - Fax:617-742-6911
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA110641223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics