Provider Demographics
NPI:1760533103
Name:REWWER, ERWIN JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERWIN
Middle Name:JOHN
Last Name:REWWER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 VALLEY TRAILS DR
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030-4904
Mailing Address - Country:US
Mailing Address - Phone:513-367-1613
Mailing Address - Fax:
Practice Address - Street 1:2818 BLUE ROCK RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-6335
Practice Address - Country:US
Practice Address - Phone:513-923-3839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH218251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice