Individual
ROSALYCE LUCILE ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1289 WINCHESTER AVE, REEDSPORT, OR 97467-1373
(888) 468-0022
Mailing address
589 REGENTS PL, REEDSPORT, OR 97467-1746
(541) 643-9846
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H1361
OR
Other
Enumeration date
06/27/2014
Last updated
06/27/2014
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