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General NPI Number Information
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NPI Number | 1356570352
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Entity Type | Individual
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Provider Name | ROSANA ROSENTRATER DMD
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Gender | Female
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Dates
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Enumeration Date | 07/11/2009
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Last Update Date | 07/18/2013
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Provider Practice Location Address
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Address Line | 240 SOUTH 40TH ST SUITE F-17 UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE
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City | PHILADELPHIA
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State | PA
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Zip | 19104-6003
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Country | US
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Telephone | 215-898-8979
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Fax | 215-746-2060
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Provider Business Mailing Address
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Address Line | 2601 PENNSYLVANIA AVE UNIT 548
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City | PHILADELPHIA
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State | PA
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Zip | 19130-2314
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Country | US
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Telephone | 267-972-8263
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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 | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DS030758L
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License Number State | PA
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