Provider Demographics
NPI:1417564121
Name:GURSIMRAN REEN, DMD LLC
Entity Type:Organization
Organization Name:GURSIMRAN REEN, DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GURSIMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:REEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:330-423-3528
Mailing Address - Street 1:29 S WEBSTER ST STE 108
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-5353
Mailing Address - Country:US
Mailing Address - Phone:630-355-5988
Mailing Address - Fax:
Practice Address - Street 1:29 S WEBSTER ST STE 108
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5353
Practice Address - Country:US
Practice Address - Phone:630-355-5988
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-26
Last Update Date:2020-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty