Provider Demographics
NPI:1841745072
Name:OSCAR D ROSARIO-PEREZ, DMD, LLC
Entity Type:Organization
Organization Name:OSCAR D ROSARIO-PEREZ, DMD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:ROSARIO PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:352-241-2021
Mailing Address - Street 1:659 W JUNIATA ST
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-2111
Mailing Address - Country:US
Mailing Address - Phone:352-241-2021
Mailing Address - Fax:
Practice Address - Street 1:659 W JUNIATA ST
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2111
Practice Address - Country:US
Practice Address - Phone:352-241-2021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20058122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty