Provider Demographics
NPI:1831305580
Name:REUSSER AND REUSSER LLC
Entity Type:Organization
Organization Name:REUSSER AND REUSSER LLC
Other - Org Name:R2CENTER FOR DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:REUSSER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:316-249-3929
Mailing Address - Street 1:2619 S ELM PL
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-7878
Mailing Address - Country:US
Mailing Address - Phone:918-455-0811
Mailing Address - Fax:918-451-4787
Practice Address - Street 1:2619 S ELM PL
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7878
Practice Address - Country:US
Practice Address - Phone:918-455-0811
Practice Address - Fax:918-451-4787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK38041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty