Provider Demographics
NPI:1326267543
Name:REICHLEY, JOSEPH PEARL (DDS)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:PEARL
Last Name:REICHLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3852 GREENBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-9719
Mailing Address - Country:US
Mailing Address - Phone:937-767-1617
Mailing Address - Fax:
Practice Address - Street 1:1450 HANES RD
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45434-6579
Practice Address - Country:US
Practice Address - Phone:937-426-5560
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH14462122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist