Provider Demographics
NPI:1003316464
Name:HAN O DDS AND M REIMELS DDS PLLC
Entity Type:Organization
Organization Name:HAN O DDS AND M REIMELS DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:N
Authorized Official - Last Name:GROESCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-978-9800
Mailing Address - Street 1:9912 MONROE RD
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5416
Mailing Address - Country:US
Mailing Address - Phone:704-847-0161
Mailing Address - Fax:
Practice Address - Street 1:9912 MONROE RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5416
Practice Address - Country:US
Practice Address - Phone:704-847-0161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty