Provider Demographics
NPI:1154365427
Name:DOSH, ROBERTA J (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERTA
Middle Name:J
Last Name:DOSH
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 1:8408 GOVERNOR BRADFORD LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-3452
Mailing Address - Country:US
Mailing Address - Phone:410-465-9288
Mailing Address - Fax:301-421-4246
Practice Address - Street 1:3905 NATIONAL DR
Practice Address - Street 2:SUITE 340
Practice Address - City:BURTONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20866-1100
Practice Address - Country:US
Practice Address - Phone:301-421-1300
Practice Address - Fax:301-421-4246
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD115651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice