Provider Demographics
NPI:1124004098
Name:ROSS, ANGELA MARIA (DDS)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:MARIA
Last Name:ROSS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 BRIAN CIR
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-4342
Mailing Address - Country:US
Mailing Address - Phone:615-834-2611
Mailing Address - Fax:615-837-1837
Practice Address - Street 1:710 HART LN
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37216-2627
Practice Address - Country:US
Practice Address - Phone:615-650-7060
Practice Address - Fax:615-262-6139
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000072011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice