Provider Demographics
NPI:1104910900
Name:ROSE HILL GENERAL AND COSMETIC DENTISTRY
Entity type:Organization
Organization Name:ROSE HILL GENERAL AND COSMETIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:P
Authorized Official - Last Name:TROILO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:316-776-2144
Mailing Address - Street 1:PO BOX 98
Mailing Address - Street 2:
Mailing Address - City:ROSE HILL
Mailing Address - State:KS
Mailing Address - Zip Code:67133-0098
Mailing Address - Country:US
Mailing Address - Phone:316-776-2144
Mailing Address - Fax:316-776-2980
Practice Address - Street 1:106 E YEAGER ST
Practice Address - Street 2:
Practice Address - City:ROSE HILL
Practice Address - State:KS
Practice Address - Zip Code:67133-9107
Practice Address - Country:US
Practice Address - Phone:316-776-2144
Practice Address - Fax:316-776-2980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5474261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental