Healthcare Provider Details

I. General information

NPI: 1285023945
Provider Name (Legal Business Name): RICHARD J. RESLER, DMD, MSD, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2015
Last Update Date: 01/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5545 COLONY DR N STE 2
SAGINAW MI
48638-7188
US

IV. Provider business mailing address

5545 COLONY DR N STE 2
SAGINAW MI
48638-7188
US

V. Phone/Fax

Practice location:
  • Phone: 989-799-5574
  • Fax: 989-799-5553
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number2901019308
License Number StateMI

VIII. Authorized Official

Name: RICHARD J RESLER JR.
Title or Position: MEMBER
Credential:
Phone: 989-799-5574