Provider Demographics
NPI:1457910101
Name:REINHARDT, EMILY RAE (DDS)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:RAE
Last Name:REINHARDT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 W GENESEE ST
Mailing Address - Street 2:
Mailing Address - City:FRANKENMUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48734-1302
Mailing Address - Country:US
Mailing Address - Phone:989-652-6196
Mailing Address - Fax:989-652-9021
Practice Address - Street 1:1025 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:FRANKENMUTH
Practice Address - State:MI
Practice Address - Zip Code:48734-1302
Practice Address - Country:US
Practice Address - Phone:989-652-6196
Practice Address - Fax:989-652-9021
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29016001151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice