Healthcare Provider Details

I. General information

NPI: 1376975334
Provider Name (Legal Business Name): RICHARD RESLER JR. D.M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2013
Last Update Date: 08/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5545 COLONY DR N SUITE #2
SAGINAW MI
48638-7188
US

IV. Provider business mailing address

5545 COLONY DR N SUITE #2
SAGINAW MI
48638-7188
US

V. Phone/Fax

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

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:
Title or Position:
Credential:
Phone: