Organization Name: | MICHAEL M BRESKIEWICZ, DMD, PC |
NPI Number: | 1962709824 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL MARTIN BRESKIEWICZ (DMD) |
Mailing Address: | 921 Chestnut St Kulpmont |
State: | PA US |
Postal Code: | 178341207 |
Phone Number: | 5703733523 |
Fax Number: | |
NPI Enumeration Date: | 02/11/2011 |
NPI Last Update Date: | 02/11/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | DS022764L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |