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Individual

DR. DANIEL EDWARD ROSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1401 INDUSTRIAL DR, COUSHATTA, LA 71019
(318) 932-2100
Mailing address
6006 84TH ST SW, MOTLEY, MN 56466-2128
(218) 397-2341

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7291
LA
1223G0001X
General Practice Dentistry
D8709
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
802518500
MN
Enumeration date
09/05/2006
Last updated
03/13/2024
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