Individual
MRS. BEVERLY ANN ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D, P. A.
Contact information
Practice address
2755 N. WICKHAM RD., SUITE 101, MELBOURNE, FL 32935
(321) 259-4666
(321) 259-3295
Mailing address
4360 WINDOVER WAY, MELBOURNE, FL 32934-8517
(321) 259-4666
(321) 259-3295
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN14369
FL
Other
Enumeration date
03/15/2007
Last updated
07/08/2007
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