Provider Demographics
NPI:1861299539
Name:ROSEBOROUGH, MILORD (RDH)
Entity type:Individual
Prefix:
First Name:MILORD
Middle Name:
Last Name:ROSEBOROUGH
Suffix:
Gender:
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13 RIVERVIEW CT APT 304
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4135
Mailing Address - Country:US
Mailing Address - Phone:301-356-4425
Mailing Address - Fax:
Practice Address - Street 1:13 RIVERVIEW CT APT 304
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-4135
Practice Address - Country:US
Practice Address - Phone:301-356-4425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7668124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist