Individual
DR. EDWARD T ROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
4 OAK DR, UNIT B, MARYVILLE, IL 62062
(618) 288-7372
Mailing address
4 OAK DR, UNIT B, MARYVILLE, IL 62062
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
IL
Other
Enumeration date
04/20/2007
Last updated
01/18/2008
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