MEDICARE: DR. ALEX STEVEN ROSNER D.M.D.

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	1223P0221X	Pediatric Dentistry	DS040819	PA
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DS040819	PA
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1255788998
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEX STEVEN ROSNER D.M.D.

Provider Business Mailing Address
First Line	:	604 S 9TH ST APT 402
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19147-2028
Country	:	US
Telephone Number	:	860-659-7985
Fax Number	:

Provider Business Practice Location Address
First Line	:	990 CITY AVE
Second Line	:
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-4005
Country	:	US
Telephone Number	:	610-649-8383
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2016
Last Update Date	:	09/05/2020

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