Provider Demographics
NPI:1457486649
Name:ROSECRANS DENTAL GROUP
Entity Type:Organization
Organization Name:ROSECRANS DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST,OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIUS
Authorized Official - Middle Name:
Authorized Official - Last Name:BADEA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-272-0222
Mailing Address - Street 1:9222 ROSECRANS AVE
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90706-2140
Mailing Address - Country:US
Mailing Address - Phone:562-272-0222
Mailing Address - Fax:562-272-0254
Practice Address - Street 1:9222 ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-2140
Practice Address - Country:US
Practice Address - Phone:562-272-0222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2008-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty