Provider Demographics
NPI:1265529754
Name:JOSEPH M ROSENWALD DDS PC
Entity type:Organization
Organization Name:JOSEPH M ROSENWALD DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSPEH
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:ROSENWALD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-947-2828
Mailing Address - Street 1:18500 OFFICE PARK DRIVE
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886
Mailing Address - Country:US
Mailing Address - Phone:301-947-2828
Mailing Address - Fax:301-947-0562
Practice Address - Street 1:18500 OFFICE PARK DRIVE
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886
Practice Address - Country:US
Practice Address - Phone:301-947-2828
Practice Address - Fax:301-947-0562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD84861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty