Provider Demographics
NPI:1669462917
Name:BRESSLER, ALLEN MARVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:MARVIN
Last Name:BRESSLER
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 1:1275 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11509-1620
Mailing Address - Country:US
Mailing Address - Phone:516-670-0190
Mailing Address - Fax:516-670-0193
Practice Address - Street 1:1532 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-2427
Practice Address - Country:US
Practice Address - Phone:718-434-5800
Practice Address - Fax:718-434-8260
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-27
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0263201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00292622Medicaid