Dr. Ivan Roman
Periodontist
3259 Catlin Ave Naval Health Clinic Quantico
Quantico
, Virginia 22134
Dr. Ivan Roman
Periodontist
3259 Catlin Ave Naval Health Clinic Quantico
Quantico
, Virginia 22134
(703) 784-2802
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Ivan Roman
- 3259 Catlin Ave Naval Health Clinic Quantico
- Quantico, VA
- Zip : 22134
- Phone : (703) 784-2802
Second Address
- Dr. Ivan Roman
- 3259 Catlin Ave Naval Health Clinic Quantico
- Quantico, VA
- Zip : 22134
- Phone : (703) 784-2802
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 40114 | CA |
National Provider Identifier
| NPI | 1023001831 |
|---|---|
| Provider Name | Dr. Ivan Roman |
| First Address | Quantico, VA 22134 |
| Second Address | Quantico, VA 22134 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/08/2005 |
| Last Update Date | 21/11/2007 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.