Provider Demographics
NPI:1235230145
Name:BARTNIK, ROSE ANN JEANETTE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROSE ANN
Middle Name:JEANETTE
Last Name:BARTNIK
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 1:683 PLUM RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1021
Mailing Address - Country:US
Mailing Address - Phone:248-370-9884
Mailing Address - Fax:248-370-9884
Practice Address - Street 1:47100 SCHOENHERR RD
Practice Address - Street 2:STE. A
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-4716
Practice Address - Country:US
Practice Address - Phone:586-566-8338
Practice Address - Fax:586-566-8339
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MI29010135391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies