Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DN14371 | FL |
NPI | 1104005008 |
---|---|
Provider Name | Dr. Sidney Charles Rosenthal |
First Address | Pensacola, FL 32503 |
Second Address | Pensacola, FL 32503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2007 |
Last Update Date | 26/10/2007 |