Provider Demographics
NPI:1730921339
Name:REID ELATTRACHE DMD PC
Entity type:Organization
Organization Name:REID ELATTRACHE DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REID
Authorized Official - Middle Name:SELIM
Authorized Official - Last Name:ELATTRACHE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:724-228-6244
Mailing Address - Street 1:250 OAK SPRING RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-2844
Mailing Address - Country:US
Mailing Address - Phone:724-228-6624
Mailing Address - Fax:724-228-8336
Practice Address - Street 1:250 OAK SPRING RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-2844
Practice Address - Country:US
Practice Address - Phone:724-228-6624
Practice Address - Fax:724-228-8336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty