# ROSE AND ROSE DDS PA

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

## Provider details

- **NPI number:** 1811193907
- **Authorized official:** DR. JOSHUA CLAYTON ROSE DDS (PRESIDENT)
- **Authorized official phone:** (252) 745-4560

## Contact information

- **Practice address:** 55 IRELAND ROAD, BAYBORO, NC 28515-0489
- **Practice address phone:** (252) 745-4560
- **Practice address fax:** (252) 745-4862
- **Mailing address:** PO BOX 489, 55 IRELAND ROAD, BAYBORO, NC 28515-0489
- **Mailing address phone:** (252) 745-4560
- **Mailing address fax:** (252) 745-4862

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 7409 | NC | — |
| 1223G0001X | General Practice Dentistry | 7479 | NC | Yes |

## Other

- **Enumeration date:** 06/25/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 7409 | STATE LICENSE OF DDS | NC |
| 01 | — | 7479 | STATE LICENSE OF DDS | NC |
| 05 | — | 89902GG | — | NC |
| 05 | — | 89902JA | — | NC |