Provider Demographics
NPI:1801366810
Name:MATTHEW S ROSENTHAL DMD LLC
Entity Type:Organization
Organization Name:MATTHEW S ROSENTHAL DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSENTHAL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:912-352-7808
Mailing Address - Street 1:1 MALL TER
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3602
Mailing Address - Country:US
Mailing Address - Phone:912-352-7808
Mailing Address - Fax:
Practice Address - Street 1:1 MALL TER
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3602
Practice Address - Country:US
Practice Address - Phone:912-352-7808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-03
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment