Individual
REBECCA J DE LA ROSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
7318 E. U.S. 36, SUITE 100, AVON, IN 46123
(317) 272-7715
(317) 272-7719
Mailing address
7318 E. U.S. 36, SUITE 100, AVON, IN 46123
(317) 272-7715
(317) 272-7719
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1200-9226
IN
Other
Enumeration date
12/26/2006
Last updated
07/08/2007
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