Individual
MARC ROSENTHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
641 W 63RD ST, CHICAGO, IL 60621-2032
(719) 589-5161
Mailing address
641 W 63RD ST, CHICAGO, IL 60621-2032
(719) 589-5161
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8416
CO
1223G0001X
General Practice Dentistry
Primary
019.030533
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019030533
—
IL
01
—
16678028
NEW MEXICO MEDICAID
—
05
—
27839770
—
CO
01
—
840706945138
ROCKY MOUNTAIN HEALTH PLA
CO
Enumeration date
10/17/2005
Last updated
07/20/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us