Provider Demographics
NPI:1134798242
Name:BRESKIEWICZ, NEIL (DDS)
Entity type:Individual
Prefix:
First Name:NEIL
Middle Name:
Last Name:BRESKIEWICZ
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 ANDREW ST
Mailing Address - Street 2:
Mailing Address - City:ELYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17824-9657
Mailing Address - Country:US
Mailing Address - Phone:570-854-8324
Mailing Address - Fax:
Practice Address - Street 1:12 ANDREW ST
Practice Address - Street 2:
Practice Address - City:ELYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17824-9657
Practice Address - Country:US
Practice Address - Phone:570-854-8324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PADS043333122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program