Provider Demographics
NPI:1386794766
Name:BRETHEL, MAUREEN CATHERINE (DDS)
Entity type:Individual
Prefix:DR
First Name:MAUREEN
Middle Name:CATHERINE
Last Name:BRETHEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3108 SUNRISE LK
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-9797
Mailing Address - Country:US
Mailing Address - Phone:570-686-3599
Mailing Address - Fax:
Practice Address - Street 1:RR 2 BOX 225
Practice Address - Street 2:
Practice Address - City:DINGMANS FERRY
Practice Address - State:PA
Practice Address - Zip Code:18328-9629
Practice Address - Country:US
Practice Address - Phone:570-828-2351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027612L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice