Provider Demographics
NPI:1811009541
Name:ROSENTHAL, ALLEN HOWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:HOWARD
Last Name:ROSENTHAL
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 1:5931 NW 61ST MNR
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4413
Mailing Address - Country:US
Mailing Address - Phone:954-345-4368
Mailing Address - Fax:954-742-2884
Practice Address - Street 1:3836 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-6300
Practice Address - Country:US
Practice Address - Phone:954-742-2577
Practice Address - Fax:954-742-2884
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL79531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice