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1730243171
GREGG LEE ROSE
CHAMPAIGN, IL
NPI
1730243171
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0221X Dentist, Pediatric Dentistry
(Licence: IL 021.001507019.021040)
Enumeration Date
2006-12-20
Last Update Date
2007-07-08
Business Address
Dr. GREGG LEE ROSE DDS
1715 BROADMOOR DR SUITE B
CHAMPAIGN, IL 61821-5983
Phone number: 217-352-7337
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Mailing Address
Dr. GREGG LEE ROSE DDS
1715 BROADMOOR DR SUITE B
CHAMPAIGN, IL 61821-5983
Phone number: 217-352-7337
Copy
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