Provider Demographics
NPI:1649343849
Name:ROSENBERG, ROBERT M (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:ROSENBERG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 887
Mailing Address - Street 2:232 BROADWAY
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-0887
Mailing Address - Country:US
Mailing Address - Phone:207-594-2124
Mailing Address - Fax:207-594-2125
Practice Address - Street 1:232 BROADWAY
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2610
Practice Address - Country:US
Practice Address - Phone:207-594-2124
Practice Address - Fax:207-594-2125
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME22911223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics