Basic Information
| Provider Information | |||||||||
| NPI: | 1942549563 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ROSS | ||||||||
| FirstName: | CARRIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | RDH | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1380 LITTLE SORRELL DRIVE | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228017370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404334913 | ||||||||
| FaxNumber: | 5404334915 | ||||||||
| Practice Location | |||||||||
| Address1: | 1380 LITTLE SORRELL DRIVE | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228017370 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404334913 | ||||||||
| FaxNumber: | 5404334915 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2013 | ||||||||
| LastUpdateDate: | 02/01/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 124Q00000X | 0402205118 | VA | Y | Dental Providers | Dental Hygienist |
No ID Information.