Provider Demographics
NPI:1457628943
Name:ROSELL, JAMEE NOELLE (RDH, DT)
Entity Type:Individual
Prefix:MRS
First Name:JAMEE
Middle Name:NOELLE
Last Name:ROSELL
Suffix:
Gender:F
Credentials:RDH, DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7020 OAK GROVE BLVD
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423
Mailing Address - Country:US
Mailing Address - Phone:612-747-9789
Mailing Address - Fax:
Practice Address - Street 1:7020 OAK GROVE BLVD
Practice Address - Street 2:
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-3039
Practice Address - Country:US
Practice Address - Phone:612-747-9789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNH5876124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist