Provider Demographics
NPI:1891359469
Name:DENTAL OUTREACH, D. AUSTIN REHL, DDS, PETER E. LOVEJOY, DDS, AND JAREK
Entity Type:Organization
Organization Name:DENTAL OUTREACH, D. AUSTIN REHL, DDS, PETER E. LOVEJOY, DDS, AND JAREK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAREK
Authorized Official - Middle Name:S
Authorized Official - Last Name:ATWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:740-374-7060
Mailing Address - Street 1:30 ACME ST
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-3306
Mailing Address - Country:US
Mailing Address - Phone:740-374-7060
Mailing Address - Fax:740-371-5116
Practice Address - Street 1:30 ACME ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-3306
Practice Address - Country:US
Practice Address - Phone:740-374-7060
Practice Address - Fax:740-371-5116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental