Organization
RUSSEL S. BLEILER, III DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSEL S. BLEILER III (DMD)
(215) 752-4646
Entity
Organization
Contact information
Practice address
360 MIDDLETOWN BLVD, SUITE 406, LANGHORNE, PA 19047-1863
(215) 752-4646
(215) 752-4650
Mailing address
360 MIDDLETOWN BLVD, SUITE 406, LANGHORNE, PA 19047-1863
(215) 752-4646
(215) 752-4650
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0354846000
IBC PROVIDER NUMBER
PA
01
—
061352
MEDICARE PROVIDER NUMBER
PA
01
—
2653716
AETNA PROVIDER NUMBER
PA
01
—
909146
HIGHMARK PROVIDER NUMBER
PA
Enumeration date
01/28/2008
Last updated
08/26/2010
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