Provider Demographics
NPI:1902919434
Name:REIGART-KISTLER DDS, INC.
Entity Type:Organization
Organization Name:REIGART-KISTLER DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:L
Authorized Official - Last Name:REIGART
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:717-225-5741
Mailing Address - Street 1:26 ROTH CHURCH RD
Mailing Address - Street 2:SPRING GROVE PROFESSIONAL CENTER
Mailing Address - City:SPRING GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:17362-1406
Mailing Address - Country:US
Mailing Address - Phone:717-225-5741
Mailing Address - Fax:717-225-3881
Practice Address - Street 1:26 ROTH CHURCH RD
Practice Address - Street 2:SPRING GROVE PROFESSIONAL CENTER
Practice Address - City:SPRING GROVE
Practice Address - State:PA
Practice Address - Zip Code:17362-1406
Practice Address - Country:US
Practice Address - Phone:717-225-5741
Practice Address - Fax:717-225-3881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADSO21682L1223G0001X
PADSO29459L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty