Provider Demographics
NPI:1952334849
Name:ROSEN, JOHN KING (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:KING
Last Name:ROSEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7532 SLATE RIDGE BLVD
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-3156
Mailing Address - Country:US
Mailing Address - Phone:614-866-8348
Mailing Address - Fax:614-866-9079
Practice Address - Street 1:7532 SLATE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-3156
Practice Address - Country:US
Practice Address - Phone:614-866-8348
Practice Address - Fax:614-866-9079
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH125531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice