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General NPI Number Information
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NPI Number | 1952576282
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Entity Type | Organization
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Legal Business Name | ROBERT A. ROSENFELD DDS (A PROFESSIONAL DENTAL CORPORATION)
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Dates
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Enumeration Date | 04/28/2008
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 116 W PLAZA ST SUITE B
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City | SOLANA BEACH
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State | CA
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Zip | 92075-1124
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Country | US
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Telephone | 858-755-1189
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Fax | 858-755-6406
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Provider Business Mailing Address
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Address Line | 116 W PLAZA ST SUITE B
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City | SOLANA BEACH
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State | CA
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Zip | 92075-1124
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Country | US
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Telephone | 858-755-1189
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Fax | 858-755-6406
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT A. ROSENFELD
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Credential | DDS
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Telephone | 858-755-1189
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 27675
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License Number State | CA
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