Individual
DR. EDWARD A. ROSENQUIST III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
5610 E CENTRAL TEXAS EXPY, SUITE 3, KILLEEN, TX 76543-5519
(301) 869-2600
(301) 208-6657
Mailing address
6046 FM 2920 RD, SUITE 406, SPRING, TX 77379-2542
(254) 213-6262
(254) 213-6268
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14687
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14687
LICENSE NUMBER
TX
01
—
611613608
BUSINESS TAX ID#
TX
Enumeration date
01/19/2007
Last updated
01/05/2011
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