Healthcare Provider Details

I. General information

NPI: 1902448046
Provider Name (Legal Business Name): HAL ROSENTHALER DMD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2019
Last Update Date: 10/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1718 WELSH RD STE B
PHILADELPHIA PA
19115-4241
US

IV. Provider business mailing address

1718 WELSH RD STE B
PHILADELPHIA PA
19115-4241
US

V. Phone/Fax

Practice location:
  • Phone: 215-673-7400
  • Fax: 215-673-5262
Mailing address:
  • Phone: 215-673-7400
  • Fax: 215-673-5262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DONNA BABIASZ
Title or Position: OFFICE MANAGER
Credential:
Phone: 215-673-7400