Provider Demographics
NPI:1912403726
Name:RESNICK, STEVEN (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:RESNICK
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 NW 39TH DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-4804
Mailing Address - Country:US
Mailing Address - Phone:352-378-6805
Mailing Address - Fax:
Practice Address - Street 1:639 NW 39TH DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-4804
Practice Address - Country:US
Practice Address - Phone:352-378-6805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN16840122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist