Provider Demographics
NPI:1639735863
Name:RESCHENTHALER AND RESCHENTHALER, DMD, PLLC
Entity Type:Organization
Organization Name:RESCHENTHALER AND RESCHENTHALER, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:POTTER
Authorized Official - Last Name:RESCHENTHALER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:412-719-0174
Mailing Address - Street 1:9555 NE DANIEL CT
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-1319
Mailing Address - Country:US
Mailing Address - Phone:412-719-0174
Mailing Address - Fax:
Practice Address - Street 1:14 BOSTON ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2319
Practice Address - Country:US
Practice Address - Phone:206-284-2136
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty