Individual
DR. MARTINE C ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2010 BREMO RD, SUITE 121, RICHMOND, VA 23226-2444
(804) 282-9191
Mailing address
2010 BREMO RD, SUITE 121, RICHMOND, VA 23226-2444
(804) 282-9191
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401007741
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146474
BLUE CROSS& BLUE SHIELD
—
01
—
172857
UNITED CONCORDIA
—
Enumeration date
07/31/2006
Last updated
07/08/2007
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