Provider Demographics
NPI:1437648490
Name:REUSSER AND REUSSER LLC
Entity Type:Organization
Organization Name:REUSSER AND REUSSER LLC
Other - Org Name:R2 CENTER FOR DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TY
Authorized Official - Middle Name:M
Authorized Official - Last Name:REUSSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-630-9500
Mailing Address - Street 1:2203 N SWEETBRIAR ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67204-5518
Mailing Address - Country:US
Mailing Address - Phone:316-838-1300
Mailing Address - Fax:
Practice Address - Street 1:2203 N SWEETBRIAR ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67204-5518
Practice Address - Country:US
Practice Address - Phone:316-838-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REUSSER AND REUSSER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-05
Last Update Date:2018-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental