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General NPI Number Information
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NPI Number | 1528197688
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Entity Type | Organization
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Legal Business Name | LARRY ROSENTHAL,DMD,PC
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 05/13/2011
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Provider Practice Location Address
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Address Line | 7143 66TH PL
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City | GLENDALE
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State | NY
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Zip | 11385-7047
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Country | US
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Telephone | 718-497-1728
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Fax | 718-497-2761
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Provider Business Mailing Address
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Address Line | 7143 66TH PL
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City | GLENDALE
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State | NY
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Zip | 11385-7047
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Country | US
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Telephone | 718-497-1728
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Fax | 718-497-2761
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Authorized Official
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Title or Position | DMD
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Name | DR. LARRY ROSENTHAL
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Credential |
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Telephone | 718-497-1728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30696
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License Number State | NY
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