Provider Demographics
NPI:1902921190
Name:REUTER, PAUL M (DDS)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:M
Last Name:REUTER
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 1:406 A HUNTINGDON PIKE
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:PA
Mailing Address - Zip Code:19046-4448
Mailing Address - Country:US
Mailing Address - Phone:215-663-1610
Mailing Address - Fax:215-663-0785
Practice Address - Street 1:406 A HUNTINGDON PIKE
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:PA
Practice Address - Zip Code:19046-4448
Practice Address - Country:US
Practice Address - Phone:215-663-1610
Practice Address - Fax:215-663-0785
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023133L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist