Provider Demographics
NPI:1659855591
Name:DANIEL ROZEN DMD PA
Entity Type:Organization
Organization Name:DANIEL ROZEN DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ROZEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-818-1734
Mailing Address - Street 1:2323 NE 26TH AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33062-1147
Mailing Address - Country:US
Mailing Address - Phone:954-719-1755
Mailing Address - Fax:954-719-7978
Practice Address - Street 1:2323 NE 26TH AVE STE 107
Practice Address - Street 2:
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33062-1147
Practice Address - Country:US
Practice Address - Phone:954-719-1755
Practice Address - Fax:954-719-7978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental