Provider Demographics
NPI:1528556883
Name:ANDREW S. ROZANSKI, D.M.D.
Entity Type:Organization
Organization Name:ANDREW S. ROZANSKI, D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZANSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:315-732-1981
Mailing Address - Street 1:1 PARIS RD
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-2476
Mailing Address - Country:US
Mailing Address - Phone:315-732-1981
Mailing Address - Fax:
Practice Address - Street 1:1 PARIS RD
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-2476
Practice Address - Country:US
Practice Address - Phone:315-732-1981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057350-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty