Provider Demographics
NPI:1467291369
Name:ROSENTHALL, ABE (DMD)
Entity type:Individual
Prefix:DR
First Name:ABE
Middle Name:
Last Name:ROSENTHALL
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 1:15473 N 200 E
Mailing Address - Street 2:
Mailing Address - City:SUMMITVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46070-9641
Mailing Address - Country:US
Mailing Address - Phone:765-212-7205
Mailing Address - Fax:
Practice Address - Street 1:15473 N 200 E
Practice Address - Street 2:
Practice Address - City:SUMMITVILLE
Practice Address - State:IN
Practice Address - Zip Code:46070-9641
Practice Address - Country:US
Practice Address - Phone:765-212-7205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program