Provider Demographics
NPI:1013027473
Name:REEN & REEN DMD PC
Entity Type:Organization
Organization Name:REEN & REEN DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:REEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD MS
Authorized Official - Phone:413-733-2477
Mailing Address - Street 1:46 DAGGETT DRIVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-4646
Mailing Address - Country:US
Mailing Address - Phone:413-733-2477
Mailing Address - Fax:413-736-9010
Practice Address - Street 1:46 DAGGETT DRIVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-4646
Practice Address - Country:US
Practice Address - Phone:413-733-2477
Practice Address - Fax:413-736-9010
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REEN & REEN DMD PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-30
Last Update Date:2008-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA103461223X0400X
MD129081223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9733981Medicaid