Provider Demographics
NPI:1174677397
Name:MARTINEZ ROSENBERG, ROSA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:
Last Name:MARTINEZ ROSENBERG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 GRASSLANDS ROAS
Mailing Address - Street 2:DENTAL 1043 WESTCHESTER MEDICAL CENTER
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1006
Mailing Address - Country:US
Mailing Address - Phone:914-493-7624
Mailing Address - Fax:914-493-8711
Practice Address - Street 1:95 GRASSLANDS ROAD
Practice Address - Street 2:WESTCHESTER MEDICAL CENTER
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595-1006
Practice Address - Country:US
Practice Address - Phone:914-493-7624
Practice Address - Fax:914-493-8711
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036651122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist