Provider Demographics
NPI:1285883728
Name:ROSENBERG, RONALD L (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:L
Last Name:ROSENBERG
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 1:329 E 65TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6863
Mailing Address - Country:US
Mailing Address - Phone:646-382-8727
Mailing Address - Fax:914-997-0566
Practice Address - Street 1:47 MAMARONECK AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4215
Practice Address - Country:US
Practice Address - Phone:914-997-0566
Practice Address - Fax:914-997-8987
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY28987122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist