Provider Demographics
NPI:1821158262
Name:REUTER, TODD JOHN (DMD, MD)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:JOHN
Last Name:REUTER
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 S TAMIAMI TRL STE 7
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-5100
Mailing Address - Country:US
Mailing Address - Phone:941-365-3388
Mailing Address - Fax:941-954-0521
Practice Address - Street 1:3300 S TAMIAMI TRL STE 7
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-5100
Practice Address - Country:US
Practice Address - Phone:941-365-3388
Practice Address - Fax:941-954-0521
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDRP3111223S0112X
FLDN16830204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery