Provider Demographics
NPI:1669677605
Name:ROSENTHAL, ALAN J (DENTIST)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:J
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:DENTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 HENRY HUDSON PKWY
Mailing Address - Street 2:SUITE 1G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1306
Mailing Address - Country:US
Mailing Address - Phone:171-854-3303
Mailing Address - Fax:171-854-3284
Practice Address - Street 1:3530 HENRY HUDSON PKWY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-1306
Practice Address - Country:US
Practice Address - Phone:171-854-3303
Practice Address - Fax:171-854-3284
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0271231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice