Provider Demographics
NPI:1851482806
Name:DRS. ROSENBERG & TAJICK
Entity Type:Organization
Organization Name:DRS. ROSENBERG & TAJICK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PHYLLIS
Authorized Official - Middle Name:REILLY
Authorized Official - Last Name:MARKIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-776-3300
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD042091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty