Provider Demographics
NPI:1811138639
Name:ROZENOVICH & AUSKER GENERAL PARTNERSHIP
Entity type:Organization
Organization Name:ROZENOVICH & AUSKER GENERAL PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GRIGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZENOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-549-1409
Mailing Address - Street 1:2720 S BRISTOL ST STE 104
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6210
Mailing Address - Country:US
Mailing Address - Phone:714-549-1409
Mailing Address - Fax:714-549-2118
Practice Address - Street 1:2720 S BRISTOL ST STE 104
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6210
Practice Address - Country:US
Practice Address - Phone:714-549-1409
Practice Address - Fax:714-549-2118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA556241223G0001X
CA401151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty