Provider Demographics
NPI:1114012820
Name:ROSS, DENNIS PAUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:PAUL
Last Name:ROSS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:DENNIS
Other - Middle Name:P
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, PA
Mailing Address - Street 1:200 W ARLINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-5762
Mailing Address - Country:US
Mailing Address - Phone:252-321-0103
Mailing Address - Fax:252-321-2348
Practice Address - Street 1:200 W ARLINGTON BLVD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5762
Practice Address - Country:US
Practice Address - Phone:252-321-0103
Practice Address - Fax:252-321-2348
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC56291223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics