Organization
ROSE AND ROSE DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSHUA CLAYTON ROSE DDS (PRESIDENT)
(252) 745-4560
Entity
Organization
Contact information
Practice address
55 IRELAND ROAD, BAYBORO, NC 28515-0489
(252) 745-4560
(252) 745-4862
Mailing address
PO BOX 489, 55 IRELAND ROAD, BAYBORO, NC 28515-0489
(252) 745-4560
(252) 745-4862
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
7409
NC
1223G0001X
General Practice Dentistry
Primary
7479
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7409
STATE LICENSE OF DDS
NC
01
—
7479
STATE LICENSE OF DDS
NC
05
—
89902GG
—
NC
05
—
89902JA
—
NC
Enumeration date
06/25/2007
Last updated
08/22/2020
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