Provider Demographics
NPI:1730257460
Name:MARQUEZ, ROSANNA (DDS)
Entity type:Individual
Prefix:DR
First Name:ROSANNA
Middle Name:
Last Name:MARQUEZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 COPPERLINE DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-4480
Mailing Address - Country:US
Mailing Address - Phone:919-960-0119
Mailing Address - Fax:
Practice Address - Street 1:1920 E. HIGHWAY 54
Practice Address - Street 2:STE 410
Practice Address - City:RESEARCH TRIANGLE PARK
Practice Address - State:NC
Practice Address - Zip Code:27713
Practice Address - Country:US
Practice Address - Phone:919-544-8106
Practice Address - Fax:919-544-8536
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC80061223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics