Provider Demographics
NPI:1982978185
Name:RSROSATI DENTAL CORP PC
Entity Type:Organization
Organization Name:RSROSATI DENTAL CORP PC
Other - Org Name:RSROSATI DENTAL CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONI
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:ROSATI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:724-981-0521
Mailing Address - Street 1:701 N HERMITAGE RD STE 4
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-3250
Mailing Address - Country:US
Mailing Address - Phone:724-981-0521
Mailing Address - Fax:724-981-9790
Practice Address - Street 1:701 N HERMITAGE RD STE 4
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-3250
Practice Address - Country:US
Practice Address - Phone:724-981-0521
Practice Address - Fax:724-981-9790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-027430-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty