Provider Demographics
NPI:1083397384
Name:PRESSLER, ERIC GRAHAM (DMD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:GRAHAM
Last Name:PRESSLER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11927 BLUE SPRUCE CT
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32223-2923
Mailing Address - Country:US
Mailing Address - Phone:215-495-8811
Mailing Address - Fax:
Practice Address - Street 1:445 STATE ROAD 13 N STE 22
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32259-2821
Practice Address - Country:US
Practice Address - Phone:904-209-6590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2023-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN285271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice