# MOUNT ROSE DENTAL PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427624592
- **Authorized official:** DR. DAVID BLACK DMD (PRESIDENT/CEO)
- **Authorized official phone:** (202) 213-1544

## Contact information

- **Practice address:** 1600 6TH AVENUE, \#109, YORK, PA 17403-2626
- **Practice address phone:** (717) 852-7475
- **Mailing address:** 922 GREEN ST, HARRISBURG, PA 17102-2914
- **Mailing address phone:** (202) 213-1544

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | NULL | Yes |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 05/31/2021
- **Last updated:** 05/31/2021