Provider Demographics
NPI:1770708992
Name:ROSS, DAVID ROBERT (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROBERT
Last Name:ROSS
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:135 E ELM AVE
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1813
Mailing Address - Country:US
Mailing Address - Phone:717-637-4131
Mailing Address - Fax:717-637-4453
Practice Address - Street 1:135 E ELM AVE
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1813
Practice Address - Country:US
Practice Address - Phone:717-637-4131
Practice Address - Fax:717-637-4453
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0361591223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics