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General NPI Number Information
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NPI Number | 1225299910
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Entity Type | Individual
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Provider Name | TRACEY HEIKEN BRESLER D.M.D
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Gender | Female
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Dates
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Enumeration Date | 06/24/2008
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Last Update Date | 01/22/2013
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Provider Practice Location Address
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Address Line | 6801 RIDGE AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19128-2446
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Country | US
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Telephone | 215-483-6633
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Fax |
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Provider Business Mailing Address
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Address Line | 834 PARADISE DR
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City | AMBLER
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State | PA
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Zip | 19002-2340
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Country | US
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Telephone | 305-725-0089
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DS038634
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DN18325
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License Number State | FL
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