Provider Demographics
NPI:1518982255
Name:RESNICK, STEVEN
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:RESNICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 INMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1132
Mailing Address - Country:US
Mailing Address - Phone:908-668-7838
Mailing Address - Fax:908-668-5645
Practice Address - Street 1:1095 INMAN AVE
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1132
Practice Address - Country:US
Practice Address - Phone:908-668-7838
Practice Address - Fax:908-668-5645
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1010859001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice