Individual
ROSIE PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-8334
Mailing address
554 KEILY STREET, CCPD BUREAU OF MED AND SURGERY, JACKSONVILLE, FL 32212
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
0402206436
VA
Other
Enumeration date
02/19/2016
Last updated
11/30/2022
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