Provider Demographics
NPI:1295818060
Name:REEL, JUSTINA INGRID TRABER (DMD)
Entity Type:Individual
Prefix:DR
First Name:JUSTINA
Middle Name:INGRID TRABER
Last Name:REEL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:JUSTINA
Other - Middle Name:INGRID
Other - Last Name:TRABER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:1325 S. BRYANT BLVD.
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903
Mailing Address - Country:US
Mailing Address - Phone:325-653-1385
Mailing Address - Fax:325-658-3300
Practice Address - Street 1:1325 S. BRYANT BLVD.
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903
Practice Address - Country:US
Practice Address - Phone:325-653-1385
Practice Address - Fax:325-658-3300
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0093641223G0001X
TX224111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice