Provider Demographics
NPI:1669682498
Name:ROSENTHAL, RICHARD M (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:M
Last Name:ROSENTHAL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WHITE HORSE RD
Mailing Address - Street 2:SUITE 916
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4406
Mailing Address - Country:US
Mailing Address - Phone:856-772-0007
Mailing Address - Fax:
Practice Address - Street 1:1000 WHITE HORSE RD
Practice Address - Street 2:SUITE 916
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4406
Practice Address - Country:US
Practice Address - Phone:856-772-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ19404122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist