Provider Demographics
NPI:1962130427
Name:BRESLIN, SOPHIA ANNE (DMD)
Entity type:Individual
Prefix:DR
First Name:SOPHIA
Middle Name:ANNE
Last Name:BRESLIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2047 PARKVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-1208
Mailing Address - Country:US
Mailing Address - Phone:215-510-8367
Mailing Address - Fax:
Practice Address - Street 1:200 YORKTOWN PLZ
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1424
Practice Address - Country:US
Practice Address - Phone:215-885-6565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS04388541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice