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General NPI Number Information
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NPI Number | 1184948143
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Entity Type | Organization
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Legal Business Name | SIDNEY M. ROSEN, D.D.S., P.C.
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Dates
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Enumeration Date | 03/19/2010
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Last Update Date | 03/19/2010
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Provider Practice Location Address
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Address Line | 455 CENTRAL PARK AVENUE SUITE 309
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City | SCARSDALE
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State | NY
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Zip | 10583
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Country | US
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Telephone | 914-725-5700
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Fax | 914-725-6340
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Provider Business Mailing Address
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Address Line | 455 CENTRAL PARK AVE SUITE 309
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City | SCARSDALE
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State | NY
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Zip | 10583
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Country | US
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Telephone | 914-725-5700
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Fax | 914-725-6340
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Authorized Official
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Title or Position | DENTIST - PRESICENT OF THE P.C.
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Name | DR. SIDNEY M. ROSEN
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Credential | D.D.S.
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Telephone | 914-725-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | #27122
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License Number State | NY
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