Provider Demographics
NPI:1841476728
Name:ROGER H. KOSLEN D.D.S., P.C.
Entity type:Organization
Organization Name:ROGER H. KOSLEN D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:KOSLEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:239-594-8108
Mailing Address - Street 1:8801 TAMIAMI TRL N
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34108-2525
Mailing Address - Country:US
Mailing Address - Phone:239-594-8108
Mailing Address - Fax:239-594-7404
Practice Address - Street 1:8801 TAMIAMI TRL N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34108-2525
Practice Address - Country:US
Practice Address - Phone:239-594-8108
Practice Address - Fax:239-594-7404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN133291223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty