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General NPI Number Information
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NPI Number | 1679622815
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Entity Type | Individual
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Provider Name | WALTER E ROSENKRANZ D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 08/06/2024
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Provider Practice Location Address
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Address Line | 29989 CANYON HILLS RD STE 1702
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City | LAKE ELSINORE
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State | CA
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Zip | 92532-2577
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Country | US
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Telephone | 951-988-0999
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Fax | 951-526-2002
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Provider Business Mailing Address
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Address Line | 29989 CANYON HILLS RD STE 1702
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City | LAKE ELSINORE
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State | CA
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Zip | 92532-2577
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Country | US
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Telephone | 951-988-0999
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Fax | 951-526-2002
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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 | 27919
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License Number State | CA
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