Provider Demographics
NPI:1689768863
Name:ROSENBERG, STEWART P (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEWART
Middle Name:P
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 1:9101 CHERRY LN
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1133
Mailing Address - Country:US
Mailing Address - Phone:301-776-3300
Mailing Address - Fax:301-725-1372
Practice Address - Street 1:9101 CHERRY LN
Practice Address - Street 2:SUITE 202
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1133
Practice Address - Country:US
Practice Address - Phone:301-776-3300
Practice Address - Fax:301-725-1372
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD042091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice