Provider Demographics
NPI:1891870150
Name:ALVETRO ROSSMAN, LISA ANN (DDS MSD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:ALVETRO ROSSMAN
Suffix:
Gender:F
Credentials:DDS MSD
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:
Other - Last Name:ALVETRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS MSD
Mailing Address - Street 1:1102 FAIRINGTON DRIVE
Mailing Address - Street 2:
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365
Mailing Address - Country:US
Mailing Address - Phone:937-492-3200
Mailing Address - Fax:937-497-7121
Practice Address - Street 1:1102 FAIRINGTON DRIVE
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365
Practice Address - Country:US
Practice Address - Phone:937-492-3200
Practice Address - Fax:937-497-7121
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH198781223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics