Individual
DR. CHENET P LAROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4400 HAVERFORD AVE, HEALTH CENTER #4, PHILADELPHIA, PA 19104-1361
(215) 685-7630
(215) 386-4902
Mailing address
500 S BROAD ST, DENTAL SUITE, PHILADELPHIA, PA 19146-1613
(215) 685-6768
(215) 685-6891
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS027302L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LA193317
1
PA
Enumeration date
08/22/2006
Last updated
07/08/2007
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