Individual
DR. ERIC BRUCE ROSENGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
24722 104TH AVE SE, SUITE 201, KENT, WA 98030-5322
(253) 859-0123
(253) 859-5864
Mailing address
24722 104TH AVE SE, SUITE 201, KENT, WA 98030-5322
(253) 859-0123
(253) 859-5864
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
60758
KS
1223G0001X
General Practice Dentistry
Primary
DE60269425
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200632500A
—
KS
Enumeration date
06/18/2009
Last updated
05/22/2012
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