Individual
DR. BROCK D ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2240 ADAMS AVE, OGDEN, UT 84401-1511
(801) 393-5355
Mailing address
251 E 300 N, CENTERVILLE, UT 84014-2047
(385) 313-4886
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11258140-9922
UT
Other
Enumeration date
04/25/2019
Last updated
04/25/2019
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