Provider Demographics
NPI:1104113208
Name:DRESLINSKI, JEREMY (OD)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:
Last Name:DRESLINSKI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1191 BYRON RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-1005
Mailing Address - Country:US
Mailing Address - Phone:517-546-4655
Mailing Address - Fax:517-546-0899
Practice Address - Street 1:1191 BYRON RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-1005
Practice Address - Country:US
Practice Address - Phone:517-546-4655
Practice Address - Fax:517-546-0899
Is Sole Proprietor?:No
Enumeration Date:2011-07-09
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6033/T2948152W00000X
MI4901004651152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist