Provider Demographics
NPI:1962646851
Name:REUSSER & REUSSER, L.L.C
Entity Type:Organization
Organization Name:REUSSER & REUSSER, L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
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:316-630-9500
Mailing Address - Street 1:13121 E 21ST ST N
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67230-7402
Mailing Address - Country:US
Mailing Address - Phone:316-630-9500
Mailing Address - Fax:316-630-9502
Practice Address - Street 1:13121 E 21ST ST N
Practice Address - Street 2:SUITE 107
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67230-7402
Practice Address - Country:US
Practice Address - Phone:316-630-9500
Practice Address - Fax:316-630-9502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2009-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty