Provider Demographics
NPI:1447273602
Name:ROSS, RODNEY B (DMD)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:B
Last Name:ROSS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 PRESQUE ISLE DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15239-2725
Mailing Address - Country:US
Mailing Address - Phone:724-327-2118
Mailing Address - Fax:724-325-1611
Practice Address - Street 1:909 PRESQUE ISLE DR
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15239-2725
Practice Address - Country:US
Practice Address - Phone:724-327-2118
Practice Address - Fax:724-325-1611
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0195621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice