Provider Demographics
NPI:1588864110
Name:BRESALIER, ALAN H (DDS)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:H
Last Name:BRESALIER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17190 ROYAL PALM BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-2379
Mailing Address - Country:US
Mailing Address - Phone:954-384-2220
Mailing Address - Fax:
Practice Address - Street 1:17190 ROYAL PALM BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-2379
Practice Address - Country:US
Practice Address - Phone:954-384-2220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-22
Last Update Date:2007-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN99941223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics