Provider Demographics
NPI:1437329554
Name:REINERSMAN, JAMES JOSEPH (DMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:JOSEPH
Last Name:REINERSMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:533 E 3RD ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-6302
Mailing Address - Country:US
Mailing Address - Phone:618-462-2607
Mailing Address - Fax:618-462-8745
Practice Address - Street 1:533 E 3RD ST
Practice Address - Street 2:SUITE 103
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-6302
Practice Address - Country:US
Practice Address - Phone:618-462-2607
Practice Address - Fax:618-462-8745
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice