Provider Demographics
NPI:1447475421
Name:ROZENSKY, RICHARD W (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:W
Last Name:ROZENSKY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8792 SE 165TH MULBERRY LN
Mailing Address - Street 2:
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32162-5861
Mailing Address - Country:US
Mailing Address - Phone:352-753-0784
Mailing Address - Fax:352-753-0796
Practice Address - Street 1:8792 SE 165TH MULBERRY LN
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32162-5861
Practice Address - Country:US
Practice Address - Phone:352-753-0784
Practice Address - Fax:352-753-0796
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL149341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice