Provider Demographics
NPI:1386777068
Name:ROSENFELD, RICHARD (DDS)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
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 1:560 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ANSONIA
Mailing Address - State:CT
Mailing Address - Zip Code:06401-2311
Mailing Address - Country:US
Mailing Address - Phone:203-735-7177
Mailing Address - Fax:
Practice Address - Street 1:560 MAIN STREET
Practice Address - Street 2:
Practice Address - City:ANSONIA
Practice Address - State:CT
Practice Address - Zip Code:06401-2311
Practice Address - Country:US
Practice Address - Phone:203-735-7177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4119122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist