Provider Demographics
NPI:1538293493
Name:SCOTT L. ROSE, D.D.S., INC.
Entity Type:Organization
Organization Name:SCOTT L. ROSE, D.D.S., INC.
Other - Org Name:THE CENTER FOR AESTHETIC AND RESTORATIVE DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-542-1200
Mailing Address - Street 1:6200 SOM CENTER RD
Mailing Address - Street 2:SUITE B-10
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2944
Mailing Address - Country:US
Mailing Address - Phone:440-542-1200
Mailing Address - Fax:440-542-1202
Practice Address - Street 1:6200 SOM CENTER RD
Practice Address - Street 2:SUITE B-10
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2944
Practice Address - Country:US
Practice Address - Phone:440-542-1200
Practice Address - Fax:440-542-1202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty