Provider Demographics
NPI:1154464972
Name:RESNICK, GENE (DMD)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:
Last Name:RESNICK
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 1:1050 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3600
Mailing Address - Country:US
Mailing Address - Phone:973-777-1772
Mailing Address - Fax:973-777-6400
Practice Address - Street 1:1050 CLIFTON AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3600
Practice Address - Country:US
Practice Address - Phone:973-777-1772
Practice Address - Fax:973-777-6400
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI162431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice