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General NPI Number Information
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NPI Number | 1952919714
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Entity Type | Organization
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Legal Business Name | BROOKLYN DENTAL GROUP, JEFFREY S. ROSENTHAL, DDS, INC.
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Dates
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Enumeration Date | 07/17/2020
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Last Update Date | 07/12/2021
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Provider Practice Location Address
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Address Line | 4163 PEARL RD.
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City | CLEVELAND
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State | OH
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Zip | 44109
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Country | US
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Telephone | 216-860-0120
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Fax | 216-860-0479
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Provider Business Mailing Address
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Address Line | 4163 PEARL RD.
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City | CLEVELAND
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State | OH
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Zip | 44109
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Country | US
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Telephone | 216-860-0120
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Fax | 216-860-0479
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Authorized Official
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Title or Position | CREDENTIALING COORDINATOR
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Name | MRS. GEORGIA PAPANDROPOULOS
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Credential |
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Telephone | 216-860-0120
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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 |
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License Number State |
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