Provider Demographics
NPI:1376674333
Name:RESNICK, LEONARD (DDS)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:
Last Name:RESNICK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 FRANKLIN AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1418
Mailing Address - Country:US
Mailing Address - Phone:201-891-9595
Mailing Address - Fax:201-891-7127
Practice Address - Street 1:841 FRANKLIN AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-1418
Practice Address - Country:US
Practice Address - Phone:201-891-9595
Practice Address - Fax:201-891-7127
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI016097001223P0700X
NY040368122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist