Individual
JACQUELINE GAIL ROSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS, MS, PC
Contact information
Practice address
355 W DUNDEE RD, SUITE 215, BUFFALO GROVE, IL 60089-3500
(847) 215-9971
(847) 215-9946
Mailing address
355 W DUNDEE RD, SUITE 215, BUFFALO GROVE, IL 60089-3500
(847) 215-9971
(847) 215-9946
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
21001225
IL
Other
Enumeration date
03/19/2013
Last updated
03/19/2013
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