Harvey Breckner, D.M.D., M.S.
Individual provider Active NPI Prosthodontics · Edwardsville, IL
NPI 1962663245 · NPPES record last updated Jun 19, 2008
Key facts
- NPI
- 1962663245
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Prosthodontics 1223P0700X
- License
- 19020061 (IL)
- Practice address
- 600 Country Club VW
Suite 4
Edwardsville, IL 62025-3696 - Phone
- (618) 307-3267
- NPI assigned
- Jun 19, 2008
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19020061 | IL | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harvey H Breckner D.M.D.,M.S | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 19020061 | IL | Yes |
Addresses
Primary practice location
600 Country Club VW
Suite 4
Edwardsville, IL 62025-3696
Mailing address
600 Country Club VW
Suite 4
Edwardsville, IL 62025-3696
Phone (618) 307-3267
Other providers in Edwardsville, IL
- Marie Alena Bradley
- Nicole Brainin
- Lukas Dean Brase
- Bravo Care of Edwardsville Inc
- Elizabeth Marie Bray
- Carl David Brickman
- Rebecca Bristow
- Abigail Kirstie Brohammer
- Abbey Brooks
- Caleb Brown
All providers in Edwardsville, IL · Prosthodontics in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 19, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.