Provider Demographics
NPI:1073297396
Name:DRS GROODY AND REIMELS PLLC
Entity Type:Organization
Organization Name:DRS GROODY AND REIMELS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:NOELLE
Authorized Official - Last Name:GROESCHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-978-9800
Mailing Address - Street 1:136 ROCKY RIVER RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28115
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:136 ROCKY RIVER RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28115
Practice Address - Country:US
Practice Address - Phone:704-782-2630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty