Provider Demographics
NPI:1841666377
Name:CIRCLE FAMILY DENTAL PC
Entity type:Organization
Organization Name:CIRCLE FAMILY DENTAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:ROSENSTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:718-792-0137
Mailing Address - Street 1:7 HUGH J GRANT CIR
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4530
Mailing Address - Country:US
Mailing Address - Phone:718-792-0137
Mailing Address - Fax:718-792-0401
Practice Address - Street 1:7 HUGH J GRANT CIR
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-4530
Practice Address - Country:US
Practice Address - Phone:718-792-0137
Practice Address - Fax:718-792-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058196122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty