Provider Demographics
NPI:1134270648
Name:GUY V REICH PA
Entity type:Organization
Organization Name:GUY V REICH PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:V
Authorized Official - Last Name:REICH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:218-732-4466
Mailing Address - Street 1:314 PLEASANT AVE S
Mailing Address - Street 2:
Mailing Address - City:PARK RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:56470-1419
Mailing Address - Country:US
Mailing Address - Phone:218-732-4466
Mailing Address - Fax:218-732-5179
Practice Address - Street 1:314 PLEASANT AVE S
Practice Address - Street 2:
Practice Address - City:PARK RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:56470-1419
Practice Address - Country:US
Practice Address - Phone:218-732-4466
Practice Address - Fax:218-732-5179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN89341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty