Provider Demographics
NPI:1922243047
Name:REICHLEY DENTAL GROUP
Entity Type:Organization
Organization Name:REICHLEY DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROCHELLE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:REICHLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:937-426-5560
Mailing Address - Street 1:1450 HANES RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45434-6579
Mailing Address - Country:US
Mailing Address - Phone:937-426-5560
Mailing Address - Fax:
Practice Address - Street 1:1450 HANES RD
Practice Address - Street 2:SUITE B
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45434-6579
Practice Address - Country:US
Practice Address - Phone:937-426-5560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0214041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1659433902OtherINDIVIDUAL NPI AS PERSON AND PRACTITIONER VERSUS CORPORATION