Provider Demographics
NPI:1154521599
Name:HARTLAND, ROSALIND IGNACIO (DMD)
Entity type:Individual
Prefix:DR
First Name:ROSALIND
Middle Name:IGNACIO
Last Name:HARTLAND
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 SOUTH MAIN STREET
Mailing Address - Street 2:PO BOX 144
Mailing Address - City:FOREST CITY
Mailing Address - State:PA
Mailing Address - Zip Code:18421-0144
Mailing Address - Country:US
Mailing Address - Phone:570-785-3000
Mailing Address - Fax:570-785-3175
Practice Address - Street 1:117 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:FOREST CITY
Practice Address - State:PA
Practice Address - Zip Code:18421-0144
Practice Address - Country:US
Practice Address - Phone:570-785-3000
Practice Address - Fax:570-785-3175
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist