Provider Demographics
NPI:1932209467
Name:ROSE, AARON E (DMD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:E
Last Name:ROSE
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 1:1475 SANSOME ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94111-1154
Mailing Address - Country:US
Mailing Address - Phone:415-398-2582
Mailing Address - Fax:415-398-2024
Practice Address - Street 1:1475 SANSOME ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-1154
Practice Address - Country:US
Practice Address - Phone:415-398-2582
Practice Address - Fax:415-398-2024
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA433911223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice