Provider Demographics
NPI:1003166273
Name:SINGH, REETANE
Entity Type:Individual
Prefix:
First Name:REETANE
Middle Name:
Last Name:SINGH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9330 BEN C PRATT SIX MILE
Mailing Address - Street 2:CYPRESS PARKWAY
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33966
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9330 BEN C PRATT SIX MILE
Practice Address - Street 2:CYPRESS PARKWAY
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33966
Practice Address - Country:US
Practice Address - Phone:239-337-1008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 199551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice