Provider Demographics
NPI:1831400787
Name:ROSARIO, OSCAR DAVID (DMD)
Entity type:Individual
Prefix:DR
First Name:OSCAR
Middle Name:DAVID
Last Name:ROSARIO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 W JUNIATA ST
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-2111
Mailing Address - Country:US
Mailing Address - Phone:352-241-2021
Mailing Address - Fax:
Practice Address - Street 1:659 W JUNIATA ST
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-2111
Practice Address - Country:US
Practice Address - Phone:352-241-2021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-25
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019028837122300000X
390200000X
FLDN20058122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program