Provider Demographics
NPI:1134344674
Name:ROSENBERG, SOL (DMD)
Entity type:Individual
Prefix:DR
First Name:SOL
Middle Name:
Last Name:ROSENBERG
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 1:632 MONTGOMERY AVE
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-2031
Mailing Address - Country:US
Mailing Address - Phone:610-667-7250
Mailing Address - Fax:610-664-5293
Practice Address - Street 1:632 MONTGOMERY AVE
Practice Address - Street 2:
Practice Address - City:NARBERTH
Practice Address - State:PA
Practice Address - Zip Code:19072-2031
Practice Address - Country:US
Practice Address - Phone:610-667-7250
Practice Address - Fax:610-664-5293
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020618L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics