Provider Demographics
NPI:1417363821
Name:ROSEMAN UNIVERSITY OF HEALTH SCIENCES, A NEVADA NON-PROFIT CORP
Entity Type:Organization
Organization Name:ROSEMAN UNIVERSITY OF HEALTH SCIENCES, A NEVADA NON-PROFIT CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:LICARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-878-1400
Mailing Address - Street 1:10894 S RIVER FRONT PKWY
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-5609
Mailing Address - Country:US
Mailing Address - Phone:801-878-1406
Mailing Address - Fax:801-878-1315
Practice Address - Street 1:10894 S RIVER FRONT PKWY
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-5609
Practice Address - Country:US
Practice Address - Phone:801-878-1406
Practice Address - Fax:801-878-1315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-07
Last Update Date:2021-05-18
Deactivation Date:2021-02-12
Deactivation Code:
Reactivation Date:2021-05-18
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty