Provider Demographics
NPI:1952570707
Name:EXETER COSMETIC DENTISTRY
Entity type:Organization
Organization Name:EXETER COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ROUZER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:610-935-7509
Mailing Address - Street 1:1288 VALLEY FORGE RD
Mailing Address - Street 2:SUITE 70
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-2687
Mailing Address - Country:US
Mailing Address - Phone:610-935-7509
Mailing Address - Fax:610-935-0625
Practice Address - Street 1:6 HEARTHSTONE CT
Practice Address - Street 2:SUITE304
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-3065
Practice Address - Country:US
Practice Address - Phone:610-370-5955
Practice Address - Fax:610-370-5957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024944L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty