Provider Demographics
NPI:1558607796
Name:JEAN REITTER, DDS, INC.
Entity Type:Organization
Organization Name:JEAN REITTER, DDS, INC.
Other - Org Name:ABSOLUTE DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:FRANCOIS
Authorized Official - Last Name:REITTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-288-8584
Mailing Address - Street 1:1809 VERDUGO BOULEVARD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208
Mailing Address - Country:US
Mailing Address - Phone:818-288-8584
Mailing Address - Fax:
Practice Address - Street 1:1809 VERDUGO BOULEVARD
Practice Address - Street 2:SUITE 207
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208
Practice Address - Country:US
Practice Address - Phone:818-288-8584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60218122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty