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Provider Information for 1982695433

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. CORY M RESNICK MD, DMD

Gender: MALE

Individual NPI: 1982695433

Calendar   Last Updated:  2020-06-01
  Certification Date:  2020-06-01

Details

Name Value
NPI 1982695433
Enumeration Date 2005-11-03
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE. BOSTON CHILDREN'S HOSPITAL, DPT. OF PLASTIC & ORAL SURG
BOSTON, MA 02171
United States

Phone: 617-355-6082 | Fax: 617-738-1657
View Map External Link
Primary Practice Address 300 LONGWOOD AVE. BOSTON CHILDREN'S HOSPITAL, DPT. OF PLASTIC & ORAL SURG
BOSTON, MA 02171
United States

Phone: 617-355-6082 | Fax: 617-738-1657
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 204E00000X - Oral & Maxillofacial Surgery MA 8458
No 1223S0112X - Dentist Oral and Maxillofacial Surgery MA DN21469