Healthcare Provider Details

I. General information

NPI: 1225183072
Provider Name (Legal Business Name): BRESLER RICHMOND DENTAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 RIDGE AVE
PHILADELPHIA PA
19128-2446
US

IV. Provider business mailing address

6801 RIDGE AVE
PHILADELPHIA PA
19128-2446
US

V. Phone/Fax

Practice location:
  • Phone: 215-483-6633
  • Fax: 215-483-7314
Mailing address:
  • Phone: 215-483-6633
  • Fax: 215-483-7314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: CINDI INJAIAN
Title or Position: FINANCIAL DIRECTOR
Credential:
Phone: 215-483-6633