Rose, Kelly S

Rose, Kelly S is an individual health care provider with primary practice located at 1100 Main St , Buffalo NY 14209-2308. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Rose, Kelly S can be contacted via phone (716) 242-8200.

Contact Information

Primary practice address
1100 Main St Buffalo NY 14209-2308
Phone: (716) 242-8200
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 050914 New York

Profile Details

NPI number 1932167145
LBN Legal business name Rose, Kelly S
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 4th, 2006
Last updated Jan 11th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932167145 NPPES
New York MEDICAID 03376083

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