Provider Demographics
NPI:1134251580
Name:DAVID A. BRESLER DDS PC
Entity type:Organization
Organization Name:DAVID A. BRESLER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:INJAIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-483-6633
Mailing Address - Street 1:6801 RIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-2446
Mailing Address - Country:US
Mailing Address - Phone:215-483-6633
Mailing Address - Fax:215-483-7909
Practice Address - Street 1:6801 RIDGE AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19128-2446
Practice Address - Country:US
Practice Address - Phone:215-483-6633
Practice Address - Fax:215-483-7909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1026336410001Medicaid