Provider Demographics
NPI:1396835385
Name:RESO, RICHARD A (DMD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:RESO
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 1:52 E BROAD ST
Mailing Address - Street 2:#7
Mailing Address - City:HOPEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08525-1842
Mailing Address - Country:US
Mailing Address - Phone:609-466-8766
Mailing Address - Fax:609-466-1446
Practice Address - Street 1:52 E BROAD ST
Practice Address - Street 2:#7
Practice Address - City:HOPEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08525-1842
Practice Address - Country:US
Practice Address - Phone:609-466-8766
Practice Address - Fax:609-466-1446
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI014716001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice