Provider Demographics
NPI:1881809804
Name:PETER S. ROSENMAN, DMD, PC
Entity type:Organization
Organization Name:PETER S. ROSENMAN, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:SETH
Authorized Official - Last Name:ROSENMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-643-9430
Mailing Address - Street 1:721 SKIPPACK PIKE
Mailing Address - Street 2:SUITE 04
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1700
Mailing Address - Country:US
Mailing Address - Phone:215-643-9430
Mailing Address - Fax:
Practice Address - Street 1:721 SKIPPACK PIKE
Practice Address - Street 2:SUITE 04
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-1700
Practice Address - Country:US
Practice Address - Phone:215-643-9430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-022404-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty