Provider Demographics
NPI:1356570352
Name:ROSENTRATER, ROSANA (DMD)
Entity type:Individual
Prefix:
First Name:ROSANA
Middle Name:
Last Name:ROSENTRATER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 PENNSYLVANIA AVE
Mailing Address - Street 2:UNIT 548
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-2314
Mailing Address - Country:US
Mailing Address - Phone:267-972-8263
Mailing Address - Fax:
Practice Address - Street 1:240 SOUTH 40TH ST SUITE F-17
Practice Address - Street 2:UNIVERSITY OF PENNSYLVANIA SCHOOL OF DENTAL MEDICINE
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-6003
Practice Address - Country:US
Practice Address - Phone:215-898-8979
Practice Address - Fax:215-746-2060
Is Sole Proprietor?:No
Enumeration Date:2009-07-11
Last Update Date:2013-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030758L1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry