Provider Demographics
NPI:1669637914
Name:REUTER, VANESSA (DDS)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:
Last Name:REUTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CHESTERFIELD BUSINESS PKWY STE 315
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63005-1271
Mailing Address - Country:US
Mailing Address - Phone:636-729-1199
Mailing Address - Fax:
Practice Address - Street 1:9133 PARKWAY E STE 101B
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35206-1500
Practice Address - Country:US
Practice Address - Phone:205-836-7276
Practice Address - Fax:205-833-7435
Is Sole Proprietor?:No
Enumeration Date:2008-07-26
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20090074361223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
12335Other12345