Provider Demographics
NPI:1659571495
Name:SOSA, ROSSANNE M (DDS)
Entity Type:Individual
Prefix:
First Name:ROSSANNE
Middle Name:M
Last Name:SOSA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7830 CLAIREMONT MESA BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1632
Mailing Address - Country:US
Mailing Address - Phone:858-496-9018
Mailing Address - Fax:858-496-9034
Practice Address - Street 1:7830 CLAIREMONT MESA BLVD STE 208
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1632
Practice Address - Country:US
Practice Address - Phone:858-496-9018
Practice Address - Fax:858-496-9034
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA514181223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry