Organization
RANDOLPH CENTER FOR ORAL AND MAXILLOFACIAL SURGERY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD A ROSENBAUM DMD (PARTNER)
(973) 328-1555
Entity
Organization
Contact information
Practice address
447 STATE ROUTE 10, SUITE 5, RANDOLPH, NJ 07869-2132
(973) 328-1555
(973) 328-3405
Mailing address
447 STATE ROUTE 10, SUITE 5, RANDOLPH, NJ 07869-2132
(973) 328-1555
(973) 328-3405
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DI02286202
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DI13367
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DI18357
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DI21013
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DI22430
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DI8562
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01984078
—
NY
05
—
01987324
—
NY
05
—
1478109
—
NJ
05
—
7796609
—
NJ
Enumeration date
05/20/2006
Last updated
08/22/2020
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