Provider Demographics
NPI:1275586661
Name:EGGLESTON, ROSANNE SCIGLIANO (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROSANNE
Middle Name:SCIGLIANO
Last Name:EGGLESTON
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 1:6883 CASCADE RD SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-6899
Mailing Address - Country:US
Mailing Address - Phone:616-949-0730
Mailing Address - Fax:
Practice Address - Street 1:6883 CASCADE RD SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-6899
Practice Address - Country:US
Practice Address - Phone:616-949-0730
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010158351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice