Organization
FAWN ROSENBERG DMD FAGD PC
Active
Other names
Fawn Rosenberg DMD FAGD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FAWN E ROSENBERG DMD, FAGD (DENTIST/OWNER)
(781) 861-6008
Entity
Organization
Contact information
Practice address
922 WALTHAM STREET, SUITE 202, LEXINGTON, MA 02421
(781) 861-6008
(781) 240-0264
Mailing address
922 WALTHAM STREET, SUITE 202, LEXINGTON, MA 02421
(781) 861-6008
(781) 240-0264
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
10473
MA
1223G0001X
General Practice Dentistry
Primary
MA16173
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X11765
BLUECROSS
—
Enumeration date
08/21/2006
Last updated
05/02/2012
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