Organization
JOHN M. ROSE, D.D.S., M.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN M. ROSE D.D.S., M.S. (ORTHODONTIST)
(815) 802-1217
Entity
Organization
Contact information
Practice address
376 LARRY POWER RD, BOURBONNAIS, IL 60914-5184
(815) 802-1217
(815) 802-1252
Mailing address
376 LARRY POWER RD, BOURBONNAIS, IL 60914-5184
(815) 802-1217
(815) 802-1252
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
IL
Other
Enumeration date
11/23/2009
Last updated
11/23/2009
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