Provider Demographics
NPI:1821112517
Name:ROSENBLATT, GREG C (DMD)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:C
Last Name:ROSENBLATT
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 1:1203 SHEFFIELD WAY
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-4414
Mailing Address - Country:US
Mailing Address - Phone:781-248-9072
Mailing Address - Fax:
Practice Address - Street 1:1203 SHEFFIELD WAY
Practice Address - Street 2:
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906-4414
Practice Address - Country:US
Practice Address - Phone:781-248-9072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA189651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice