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Individual

DR. LAUREN SUZANNE ROSELLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
3 PARK STREET, DOTY DENTAL, GENESEO, NY 14454
(585) 243-6569
Mailing address
3 PARK STREET, DOTY DENTAL, GENESEO, NY 14454
(585) 243-6569

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
051367
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000408997001
BC/BS
NY
05
01034940
NY
01
135759
GUARDIAN
NY
01
4012996
INDEPENDENT HEALTH
NY
01
917848
DORAL
NY
Enumeration date
10/11/2006
Last updated
09/14/2007
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