Provider Demographics
NPI:1316963473
Name:ROSLAND, RODNEY (DDS)
Entity type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:
Last Name:ROSLAND
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 BACHMAN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-7220
Mailing Address - Country:US
Mailing Address - Phone:408-354-2705
Mailing Address - Fax:408-354-6560
Practice Address - Street 1:218 BACHMAN AVE
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-7220
Practice Address - Country:US
Practice Address - Phone:408-354-2705
Practice Address - Fax:408-354-6560
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA262251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice