Individual
PAUL ANTHONY ROSSETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019034743
IL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
019.034743
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/25/2020
Last updated
11/14/2024
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