Provider Demographics
NPI:1093731796
Name:ALLAN J. ROSENBERG, D.D.S., INC.
Entity Type:Organization
Organization Name:ALLAN J. ROSENBERG, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-860-6626
Mailing Address - Street 1:10929 SOUTH ST
Mailing Address - Street 2:SUITE 110-B
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-5340
Mailing Address - Country:US
Mailing Address - Phone:562-860-6626
Mailing Address - Fax:562-860-6628
Practice Address - Street 1:10929 SOUTH ST
Practice Address - Street 2:SUITE 110-B
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-5340
Practice Address - Country:US
Practice Address - Phone:562-860-6626
Practice Address - Fax:562-860-6628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA219411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty