Provider Demographics
NPI:1194737015
Name:ROSENFELD, ROBERT A (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:ROSENFELD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W PLAZA ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1124
Mailing Address - Country:US
Mailing Address - Phone:858-755-1189
Mailing Address - Fax:858-755-6406
Practice Address - Street 1:116 W PLAZA ST
Practice Address - Street 2:SUITE B
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1124
Practice Address - Country:US
Practice Address - Phone:858-755-1189
Practice Address - Fax:858-755-6406
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA276751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice