Provider Demographics
NPI:1962672063
Name:FELD & ROSENBERG DENTAL PARTNERSHIP
Entity Type:Organization
Organization Name:FELD & ROSENBERG DENTAL PARTNERSHIP
Other - Org Name:SAN GABRIEL VALLEY FAMILY DENTAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:626-286-2156
Mailing Address - Street 1:6503 ROSEMEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91775-1936
Mailing Address - Country:US
Mailing Address - Phone:626-286-2156
Mailing Address - Fax:626-286-2598
Practice Address - Street 1:6503 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91775-1936
Practice Address - Country:US
Practice Address - Phone:626-286-2156
Practice Address - Fax:626-286-2598
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAN GABRIEL VALLEY FAMILY DENTAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA256211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty