Individual
DR. VANESSA DE LA ROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
8905 TWO NOTCH RD, COLUMBIA, SC 29223-6367
(803) 830-4387
Mailing address
8905 TWO NOTCH RD, COLUMBIA, SC 29223-6367
(803) 830-4387
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
102718
CA
1223P0221X
Pediatric Dentistry
11285
OR
1223P0221X
Pediatric Dentistry
Primary
DGD.10161
SC
Other
Enumeration date
07/06/2018
Last updated
05/05/2022
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