Provider Demographics
NPI:1396850772
Name:REIFMAN, EDWARD MARTIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:MARTIN
Last Name:REIFMAN
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 1:8330 E HARTFORD DR STE 100
Mailing Address - Street 2:RM A
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7205
Mailing Address - Country:US
Mailing Address - Phone:480-745-3547
Mailing Address - Fax:888-400-2918
Practice Address - Street 1:8330 E HARTFORD DR STE 100
Practice Address - Street 2:RM A
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7205
Practice Address - Country:US
Practice Address - Phone:480-745-3547
Practice Address - Fax:888-400-2918
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9139122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist