Individual
MICHAEL DAVID ROSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MPH
Contact information
Practice address
230 S 12TH AVE, PHOENIX, AZ 85007-3101
(424) 279-4564
Mailing address
230 S 12TH AVE, PHOENIX, AZ 85007-3101
(424) 279-4564
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
105379
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
D011353
AZ
Other
Enumeration date
08/26/2020
Last updated
05/03/2024
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