Provider Demographics
NPI:1144484429
Name:CRANBERRY FAMILY DENTISTRY P.C.
Entity type:Organization
Organization Name:CRANBERRY FAMILY DENTISTRY P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROSENZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-742-1700
Mailing Address - Street 1:20215 ROUTE 19
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-6146
Mailing Address - Country:US
Mailing Address - Phone:724-742-1700
Mailing Address - Fax:724-742-1722
Practice Address - Street 1:20215 ROUTE 19
Practice Address - Street 2:SUITE 100
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-6146
Practice Address - Country:US
Practice Address - Phone:724-742-1700
Practice Address - Fax:724-742-1722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-15
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-031606-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty