Provider Demographics
NPI:1174664312
Name:ROTHSTEIN, MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:ROTHSTEIN
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 1:16 SQUADRON BLVD
Mailing Address - Street 2:SUITE #105
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5259
Mailing Address - Country:US
Mailing Address - Phone:845-634-8866
Mailing Address - Fax:
Practice Address - Street 1:16 SQUADRON BLVD
Practice Address - Street 2:SUITE #105
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-5259
Practice Address - Country:US
Practice Address - Phone:845-634-8866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0459541223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics