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General NPI Number Information
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NPI Number | 1093749251
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Entity Type | Organization
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Legal Business Name | ROBERT A. ROSENBAUM, DDS, INC.
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2200 MCHENRY AVE STE B
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City | MODESTO
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State | CA
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Zip | 95350-3255
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Country | US
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Telephone | 209-526-9132
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Fax | 209-526-9131
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Provider Business Mailing Address
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Address Line | 2200 MCHENRY AVE STE B
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City | MODESTO
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State | CA
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Zip | 95350-3255
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Country | US
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Telephone | 209-526-9132
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Fax | 209-526-9131
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Authorized Official
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Title or Position | PRESIDENT/ DENTIST
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Name | DR. ROBERT A ROSENBAUM
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Credential | DDS
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Telephone | 209-526-9132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 31100
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License Number State | CA
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