Provider Demographics
NPI:1295822765
Name:PAUL J ROSENBLITT DDS INC
Entity Type:Organization
Organization Name:PAUL J ROSENBLITT DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:ROSENBLITT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:216-281-2444
Mailing Address - Street 1:1148 EUCLID AVENUE
Mailing Address - Street 2:SUITE 317
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-1604
Mailing Address - Country:US
Mailing Address - Phone:216-781-2444
Mailing Address - Fax:216-781-0990
Practice Address - Street 1:1148 EUCLID AVENUE
Practice Address - Street 2:SUITE 317
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-1604
Practice Address - Country:US
Practice Address - Phone:216-781-2444
Practice Address - Fax:216-781-0990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH215431223G0001X
FLDN155911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
01593816OtherUNITED CONCORDIA OF PA