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General NPI Number Information
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NPI Number | 1568681864
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Entity Type | Organization
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Legal Business Name | ROBERT D. ROSENBERG, D.D.S., P.C.
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 109 BOSTON POST RD
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City | ORANGE
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State | CT
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Zip | 06477-3235
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Country | US
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Telephone | 203-795-1209
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Fax | 203-795-6911
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Provider Business Mailing Address
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Address Line | 109 BOSTON POST RD
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City | ORANGE
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State | CT
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Zip | 06477-3235
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Country | US
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Telephone | 203-795-1209
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Fax | 203-795-6911
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT DAVID ROSENBERG
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Credential | D.D.S.
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Telephone | 203-795-1209
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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 | 8223
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License Number State | CT
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