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General NPI Number Information
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NPI Number | 1164658076
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Entity Type | Organization
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Legal Business Name | ROBERT M. ROSENBERG, D.D.S., PA
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Dates
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Enumeration Date | 06/05/2009
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Last Update Date | 06/05/2009
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Provider Practice Location Address
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Address Line | 232 BROADWAY
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City | ROCKLAND
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State | ME
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Zip | 04841-2610
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Country | US
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Telephone | 207-594-2124
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Fax | 207-594-2125
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Provider Business Mailing Address
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Address Line | PO BOX 887 232 BROADWAY
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City | ROCKLAND
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State | ME
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Zip | 04841-0887
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Country | US
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Telephone | 207-594-2124
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Fax | 207-594-2124
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Authorized Official
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Title or Position | OWNER/DOCTOR
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Name | DR. ROBERT M ROSENBERG
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Credential | ORTHODONTIST
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Telephone | 207-594-2124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2291
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License Number State | ME
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