Clarence Vernon Rose Jr., DDS
Individual provider Active NPI General Practice Dentistry · Bayboro, NC
NPI 1891894549 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1891894549
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- NC3825 (NC)
- Practice address
- 55 Ireland Road
Bayboro, NC 28515 - Phone
- (252) 745-4560
- Fax
- (252) 745-4862
- NPI assigned
- Sep 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NC3825 | NC | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rose and Rose DDS PA | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | NC3825 | NC | Yes |
Addresses
Primary practice location
55 Ireland Road
Bayboro, NC 28515
Mailing address
PO Box 489
Bayboro, NC 28515
Phone (252) 745-4560
Other providers in Bayboro, NC
- Port Human Services
- Teri Marla Friedman Reid
- Rha Health Services Inc
- Rha Health Services, Inc.
- Rose and Rose DDS PA
- Joshua Clayton Rose
- Rebecca Bolling Rose
- Sand and Sandals Outreach Ministries
- Sand and Sandals Outreach Ministries
- Dana Schelegle
All providers in Bayboro, NC · General Practice Dentistry in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.