Rosenbaum, Michael

Rosenbaum, Michael is an individual health care provider with primary practice located at 6404 Roosevelt Blvd , Philadelphia PA 19149-2943. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Rosenbaum, Michael can be contacted via phone (215) 743-3700.

Contact Information

Primary practice address
6404 Roosevelt Blvd Philadelphia PA 19149-2943
Phone: (215) 743-3700
Fax: (215) 743-3706
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DS025205L Pennsylvania

Profile Details

NPI number 1104810530
LBN Legal business name Rosenbaum, Michael
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2005
Last updated Apr 2nd, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104810530 NPPES
Pennsylvania MEDICAID 001148784

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