Provider Demographics
NPI:1679622815
Name:ROSENKRANZ, WALTER E (DMD)
Entity type:Individual
Prefix:DR
First Name:WALTER
Middle Name:E
Last Name:ROSENKRANZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:WALTER
Other - Middle Name:E
Other - Last Name:ROSENKRANZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:29989 CANYON HILLS RD STE 1702
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-2577
Mailing Address - Country:US
Mailing Address - Phone:951-988-0999
Mailing Address - Fax:951-526-2002
Practice Address - Street 1:29989 CANYON HILLS RD STE 1702
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92532-2577
Practice Address - Country:US
Practice Address - Phone:951-988-0999
Practice Address - Fax:951-526-2002
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA279191223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry