Provider Demographics
NPI:1982238309
Name:REUSSER AND REUSSER, LLC
Entity Type:Organization
Organization Name:REUSSER AND REUSSER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNDER
Authorized Official - Prefix:
Authorized Official - First Name:TY
Authorized Official - Middle Name:M
Authorized Official - Last Name:REUSSER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:316-630-9500
Mailing Address - Street 1:1629 POYNTZ AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-4148
Mailing Address - Country:US
Mailing Address - Phone:785-776-1771
Mailing Address - Fax:
Practice Address - Street 1:1629 POYNTZ AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-4148
Practice Address - Country:US
Practice Address - Phone:785-776-1771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental