MEDICARE: ROSENBAUM DENTAL CORP

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
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1093532731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSENBAUM DENTAL CORP

Provider Business Mailing Address
First Line	:	10538 VENICE BLVD
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90232-3308
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10538 VENICE BLVD
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90232-3308
Country	:	US
Telephone Number	:	310-838-1069
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. BENJAMIN ROSENBAUM
Credential	:	DDS
Telephone Number	:	310-838-1069

Provider Enumeration Date	:	09/24/2024
Last Update Date	:	09/24/2024

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Directions to “ROSENBAUM DENTAL CORP ” Practice Location

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