Provider Demographics
NPI:1336222090
Name:REICH, RICHARD LELAND (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:LELAND
Last Name:REICH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 E CAROLINE ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-4002
Mailing Address - Country:US
Mailing Address - Phone:775-882-7676
Mailing Address - Fax:775-882-8782
Practice Address - Street 1:602 E CAROLINE ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-4002
Practice Address - Country:US
Practice Address - Phone:775-882-7676
Practice Address - Fax:775-882-8782
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice