Individual
DR. LANDI JENNIFER ROSENAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
9456 CHARLOTTE HWY STE 202, INDIAN LAND, SC 29707-7953
(803) 766-7973
Mailing address
958 MEADOW VISTA DR, WAXHAW, NC 28173-5011
(704) 607-1678
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
10814
NC
1223G0001X
General Practice Dentistry
Primary
9798
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10814
DENTAL LISENCE
NC
01
—
9798
DENTAL LISENCE
SC
Enumeration date
07/21/2017
Last updated
08/10/2021
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