Provider Demographics
NPI:1073660981
Name:REIGHARD, BARBARA KAST (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:KAST
Last Name:REIGHARD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 SANDCASTLE WAY
Mailing Address - Street 2:
Mailing Address - City:ST SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522-3729
Mailing Address - Country:US
Mailing Address - Phone:404-786-0229
Mailing Address - Fax:
Practice Address - Street 1:213 SANDCASTLE WAY
Practice Address - Street 2:
Practice Address - City:ST SIMONS ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31522-3729
Practice Address - Country:US
Practice Address - Phone:404-786-0229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN007629122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist