Provider Demographics
NPI:1306985692
Name:ROSSMAN, LOUIS ELLIOTT (DMD FACD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:ELLIOTT
Last Name:ROSSMAN
Suffix:
Gender:M
Credentials:DMD FACD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1601 WALNUT STREET
Mailing Address - Street 2:SUITE 1114
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102
Mailing Address - Country:US
Mailing Address - Phone:215-563-5181
Mailing Address - Fax:215-563-3467
Practice Address - Street 1:1601 WALNUT STREET
Practice Address - Street 2:SUITE 1114
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102
Practice Address - Country:US
Practice Address - Phone:215-563-5181
Practice Address - Fax:215-563-3467
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PADS019051L1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA159068OtherUNITED CONCORDIA