Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 0401413180 | VA |
NPI | 1003102476 |
---|---|
Provider Name | Dr. Ashley Diana Rosinski |
First Address | Gainesville, VA 20155-1022 |
Second Address | Manassas, VA 20109-4403 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2011 |
Last Update Date | 23/06/2011 |