Provider Demographics
NPI:1962684498
Name:RICHARD W ROZENSKY DDS PA
Entity Type:Organization
Organization Name:RICHARD W ROZENSKY DDS PA
Other - Org Name:VILLAGE SLEEP DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:ROZENSKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:352-430-1710
Mailing Address - Street 1:1950 LAUREL MANOR DR STE 180
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-5608
Mailing Address - Country:US
Mailing Address - Phone:352-430-1710
Mailing Address - Fax:352-753-0796
Practice Address - Street 1:1950 LAUREL MANOR DR STE 180
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5608
Practice Address - Country:US
Practice Address - Phone:352-430-1710
Practice Address - Fax:352-753-0796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-27
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN16691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty