Provider Demographics
NPI:1770837783
Name:REHM, JAMES W (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:REHM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11311 FAIRWAYS DR
Mailing Address - Street 2:
Mailing Address - City:CREVE COEUR
Mailing Address - State:MO
Mailing Address - Zip Code:63141-7526
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12000 BELLEFONTAINE RD
Practice Address - Street 2:CIGNO DENTAL CARE
Practice Address - City:ST. LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63138
Practice Address - Country:US
Practice Address - Phone:314-741-5133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012023480122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist