Provider Demographics
NPI:1659402527
Name:ROSS, STUART (DMD)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:
Last Name:ROSS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 ARLINGTON ST
Mailing Address - Street 2:STE 205
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-1053
Mailing Address - Country:US
Mailing Address - Phone:941-955-2299
Mailing Address - Fax:941-951-6699
Practice Address - Street 1:67 JEFFERSON BOULVARD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888-1053
Practice Address - Country:US
Practice Address - Phone:401-781-2742
Practice Address - Fax:401-781-2740
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN016411223P0300X
FLDN83661223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN8366OtherSTATE DENTAL LIC
RIDEN 01641OtherSTATE DENTAL LIC