Individual
CHARLES ROSENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1005 E LASALLE AVE, SOUTH BEND, IN 46617-2818
(574) 245-7501
Mailing address
1005 EAST LASALLE AVENUE, SOUTH BEND, IN 46617
(574) 245-7501
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12005961
IN
Other
Enumeration date
07/05/2006
Last updated
07/08/2007
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