Provider Demographics
NPI:1922559731
Name:ROSSVIEW DENTAL PLLC
Entity Type:Organization
Organization Name:ROSSVIEW DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:PALOMAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:931-802-6875
Mailing Address - Street 1:329 WARFIELD BLVD STE G
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-5688
Mailing Address - Country:US
Mailing Address - Phone:931-802-6875
Mailing Address - Fax:
Practice Address - Street 1:329 WARFIELD BLVD STE G
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-5688
Practice Address - Country:US
Practice Address - Phone:931-802-6875
Practice Address - Fax:931-802-6877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8672122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty