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General NPI Number Information
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NPI Number | 1174664312
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Entity Type | Individual
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Provider Name | MICHAEL ROTHSTEIN D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 11/07/2008
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Provider Practice Location Address
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Address Line | 16 SQUADRON BLVD SUITE #105
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City | NEW CITY
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State | NY
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Zip | 10956-5259
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Country | US
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Telephone | 845-634-8866
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Fax |
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Provider Business Mailing Address
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Address Line | 16 SQUADRON BLVD SUITE #105
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City | NEW CITY
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State | NY
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Zip | 10956-5259
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Country | US
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Telephone | 845-634-8866
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 045954
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License Number State | NY
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