Provider Demographics
NPI:1518021005
Name:RIESENBERGER, JAMES D (DMD MSD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:RIESENBERGER
Suffix:
Gender:M
Credentials:DMD MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:111 C FLORAL VALE BLVD
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067
Mailing Address - Country:US
Mailing Address - Phone:215-968-5471
Mailing Address - Fax:215-860-9806
Practice Address - Street 1:111 C FLORAL VALE BLVD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067
Practice Address - Country:US
Practice Address - Phone:215-968-5471
Practice Address - Fax:215-860-9806
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS030036L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics