Provider Demographics
NPI:1992726244
Name:RESUE, DALE C II (DMD)
Entity type:Individual
Prefix:DR
First Name:DALE
Middle Name:C
Last Name:RESUE
Suffix:II
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1999 SPROUL RD
Mailing Address - Street 2:SUITE 15
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3508
Mailing Address - Country:US
Mailing Address - Phone:610-325-4444
Mailing Address - Fax:610-325-6993
Practice Address - Street 1:1999 SPROUL RD
Practice Address - Street 2:SUITE 15
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008-3508
Practice Address - Country:US
Practice Address - Phone:610-325-4444
Practice Address - Fax:610-325-6993
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2016-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS017839-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice