Provider Demographics
NPI:1164510541
Name:REISIG, GREER CIEUTAT (DDS)
Entity Type:Individual
Prefix:DR
First Name:GREER
Middle Name:CIEUTAT
Last Name:REISIG
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 1:337 METAIRE RONO
Mailing Address - Street 2:SUITE 200
Mailing Address - City:METAIRE
Mailing Address - State:LA
Mailing Address - Zip Code:70005
Mailing Address - Country:US
Mailing Address - Phone:504-832-2043
Mailing Address - Fax:504-832-1979
Practice Address - Street 1:337 METAIRE RONO
Practice Address - Street 2:SUITE 200
Practice Address - City:METAIRE
Practice Address - State:LA
Practice Address - Zip Code:70005
Practice Address - Country:US
Practice Address - Phone:504-832-2043
Practice Address - Fax:504-832-1979
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA44161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1844161Medicaid