Provider Demographics
NPI:1205040755
Name:ROSEMOND, HANIEL CHYLER (DDS, FAGD)
Entity Type:Individual
Prefix:
First Name:HANIEL
Middle Name:CHYLER
Last Name:ROSEMOND
Suffix:
Gender:M
Credentials:DDS, FAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:481 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-2642
Mailing Address - Country:US
Mailing Address - Phone:973-762-2660
Mailing Address - Fax:973-762-5473
Practice Address - Street 1:481 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-2642
Practice Address - Country:US
Practice Address - Phone:973-762-2660
Practice Address - Fax:973-762-5473
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ165641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice