Provider Demographics
NPI:1861870396
Name:LAWRENCE L RESSLER DMD PA
Entity type:Organization
Organization Name:LAWRENCE L RESSLER DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:LOWELL
Authorized Official - Last Name:RESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:561-499-7400
Mailing Address - Street 1:15300 JOG RD STE 201
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2166
Mailing Address - Country:US
Mailing Address - Phone:561-499-7400
Mailing Address - Fax:
Practice Address - Street 1:15300 JOG RD STE 201
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-2166
Practice Address - Country:US
Practice Address - Phone:561-499-7400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-17
Last Update Date:2015-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15228122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty