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NPI Code Detail

MEDICARE: DR. STEPHEN B ROTHENBERG DDS

MEDICARE: DR. STEPHEN B ROTHENBERG DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist7410FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083802052
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. STEPHEN B ROTHENBERG DDS
Provider Business Mailing Address
First Line : 416 E HALLANDALE BEACH BLVD
Second Line :
City : HALLANDALE BEACH
State : FL
Zip : 33009-5529
Country : US
Telephone Number : 954-457-8288
Fax Number : 954-457-8819
Provider Business Practice Location Address
First Line : 416 E HALLANDALE BEACH BLVD
Second Line :
City : HALLANDALE BEACH
State : FL
Zip : 33009-5529
Country : US
Telephone Number : 954-457-8288
Fax Number : 954-457-8819
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2007
Last Update Date : 10/04/2007

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