MEDICARE: ROSENBLATT & FIRTEL DDS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	43598	CA

General Provider Information

NPI Number	:	1104839158
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSENBLATT & FIRTEL DDS INC

Provider Business Mailing Address
First Line	:	3222 GOVERNOR DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122
Country	:	US
Telephone Number	:	858-453-8520
Fax Number	:	858-453-8724

Provider Business Practice Location Address
First Line	:	3222 GOVERNOR DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122
Country	:	US
Telephone Number	:	858-453-8520
Fax Number	:	858-453-8724

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RONALD SHELDON ROSENBLATT
Credential	:	DDS
Telephone Number	:	858-453-8520

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	08/22/2020

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