Provider Demographics
NPI:1598005191
Name:HYDEMAN, ROSEMARY T (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROSEMARY
Middle Name:T
Last Name:HYDEMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 CLYDESDALE CT
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-1512
Mailing Address - Country:US
Mailing Address - Phone:724-468-8502
Mailing Address - Fax:724-468-6161
Practice Address - Street 1:2370 ROUTE 66
Practice Address - Street 2:
Practice Address - City:DELMONT
Practice Address - State:PA
Practice Address - Zip Code:15626-1454
Practice Address - Country:US
Practice Address - Phone:724-468-8502
Practice Address - Fax:724-468-6161
Is Sole Proprietor?:No
Enumeration Date:2013-02-20
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0229261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice