Provider Demographics
NPI:1477631562
Name:ROSENBERG, HOWARD MARVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:MARVIN
Last Name:ROSENBERG
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 1:202 TOWER RD
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-1214
Mailing Address - Country:US
Mailing Address - Phone:610-525-7959
Mailing Address - Fax:
Practice Address - Street 1:4001 SPRUCE ST
Practice Address - Street 2:PEDIATRIC DENTISTRY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4118
Practice Address - Country:US
Practice Address - Phone:215-898-7663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017602L1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry