Healthcare Provider Details

I. General information

NPI: 1689479859
Provider Name (Legal Business Name): KATHRYN REUTHER DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3613 RICHARDSON SQUARE DR STE 100
ARNOLD MO
63010-6027
US

IV. Provider business mailing address

3613 RICHARDSON SQUARE DR STE 100
ARNOLD MO
63010-6027
US

V. Phone/Fax

Practice location:
  • Phone: 636-461-0093
  • Fax: 636-461-0229
Mailing address:
  • Phone: 636-461-0093
  • Fax: 636-461-0229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. KATHRYN ELIZABETH REUTHER
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 636-461-0093