Provider Demographics
NPI:1588642664
Name:ROSNEBLATT, DEBRA R (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:R
Last Name:ROSNEBLATT
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 1:251 GODWIN AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1807
Mailing Address - Country:US
Mailing Address - Phone:201-445-2797
Mailing Address - Fax:201-445-8340
Practice Address - Street 1:251 GODWIN AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1807
Practice Address - Country:US
Practice Address - Phone:201-445-2797
Practice Address - Fax:201-445-8340
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DIO14180001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice