Provider Demographics
NPI:1740299569
Name:REITTER, ERIK F (DDS)
Entity type:Individual
Prefix:
First Name:ERIK
Middle Name:F
Last Name:REITTER
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 1:1851 WELLNESS BLVD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NC
Mailing Address - Zip Code:28110-7774
Mailing Address - Country:US
Mailing Address - Phone:704-291-7333
Mailing Address - Fax:704-292-1203
Practice Address - Street 1:1851 WELLNESS BLVD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28110-7774
Practice Address - Country:US
Practice Address - Phone:704-291-7333
Practice Address - Fax:704-292-1203
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH035511223S0112X
NC87491223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery