Provider Demographics
NPI:1336435908
Name:ROSELLINI, ELIZABETH SUZANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:SUZANNE
Last Name:ROSELLINI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 CALLE MENDEZ VIGO
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-4908
Mailing Address - Country:US
Mailing Address - Phone:214-642-6244
Mailing Address - Fax:
Practice Address - Street 1:330 CALLE MENDEZ VIGO
Practice Address - Street 2:
Practice Address - City:DORADO
Practice Address - State:PR
Practice Address - Zip Code:00646-4908
Practice Address - Country:US
Practice Address - Phone:214-642-6244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27576122300000X
PR3388122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist