Provider Demographics
NPI:1659154193
Name:REINECKER DENTAL, LLC
Entity Type:Organization
Organization Name:REINECKER DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:REINECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:610-777-1001
Mailing Address - Street 1:206 REVERE BLVD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19609-2463
Mailing Address - Country:US
Mailing Address - Phone:610-777-1001
Mailing Address - Fax:610-777-4914
Practice Address - Street 1:206 REVERE BLVD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19609-2463
Practice Address - Country:US
Practice Address - Phone:610-777-1001
Practice Address - Fax:610-777-4914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental