Provider Demographics
NPI:1184881963
Name:ADRIAN P REHAK, DDS, PC
Entity type:Organization
Organization Name:ADRIAN P REHAK, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:REHAK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:319-362-3179
Mailing Address - Street 1:4015 MOUNT VERNON RD SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-3891
Mailing Address - Country:US
Mailing Address - Phone:319-362-3179
Mailing Address - Fax:319-362-9586
Practice Address - Street 1:4015 MOUNT VERNON RD SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-3891
Practice Address - Country:US
Practice Address - Phone:319-362-3179
Practice Address - Fax:319-362-9586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA6205261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA6205OtherDELTA DENTAL