Provider Demographics
NPI:1376695411
Name:DAVID P ROSSITER III DMD PC
Entity Type:Organization
Organization Name:DAVID P ROSSITER III DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:ROSSITER
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:413-586-2151
Mailing Address - Street 1:241 KING STREET
Mailing Address - Street 2:SUITE 114
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2393
Mailing Address - Country:US
Mailing Address - Phone:413-586-2151
Mailing Address - Fax:413-586-2525
Practice Address - Street 1:241 KING STREET
Practice Address - Street 2:SUITE 114
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2393
Practice Address - Country:US
Practice Address - Phone:413-586-2151
Practice Address - Fax:413-586-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA113231223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty