Provider Demographics
NPI:1790824415
Name:REAMER, ERNEST D (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:D
Last Name:REAMER
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:PO BOX 222
Mailing Address - Street 2:62 MAIN STREET
Mailing Address - City:CENTERBROOK
Mailing Address - State:CT
Mailing Address - Zip Code:06409-0222
Mailing Address - Country:US
Mailing Address - Phone:860-767-0639
Mailing Address - Fax:860-767-1334
Practice Address - Street 1:62 MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTERBROOK
Practice Address - State:CT
Practice Address - Zip Code:06409-1001
Practice Address - Country:US
Practice Address - Phone:860-767-0639
Practice Address - Fax:860-767-1334
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT45521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice