Healthcare Provider Details

I. General information

NPI: 1235325192
Provider Name (Legal Business Name): SPECIAL TOUCH DENTISTRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2007
Last Update Date: 03/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 GEIGER ROAD
PHILADELPHIA PA
19115
US

IV. Provider business mailing address

240 GEIGER ROAD
PHILADELPHIA PA
19115
US

V. Phone/Fax

Practice location:
  • Phone: 215-508-4200
  • Fax: 215-969-0215
Mailing address:
  • Phone: 215-677-0380
  • Fax: 215-969-0215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS-023790-1
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA BRESLER
Title or Position: OWNER
Credential: DMD
Phone: 215-677-0380