Individual
DR. JENNIFER ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
50 N MEDICAL DR,, UNIVERSITY HOSPITAL, SALT LAKE CITY, UT 84112
(785) 760-7244
Mailing address
50 N MEDICAL DR,, UNIVERSITY HOSPITAL, SALT LAKE CITY, UT 84112
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12012212A
IN
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/17/2015
Last updated
04/17/2015
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