Healthcare Provider Details

I. General information

NPI: 1437319571
Provider Name (Legal Business Name): MICHAEL O REIMELS, DDS & CATHERINE G REIMELS, DDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 04/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13605 REESE BLVD WEST
HUNTERSVILLE NC
28078-6445
US

IV. Provider business mailing address

13605 REESE BLVD WEST
HUNTERSVILLE NC
28078-6445
US

V. Phone/Fax

Practice location:
  • Phone: 704-948-1111
  • Fax: 704-948-1991
Mailing address:
  • Phone: 704-948-1111
  • Fax: 704-948-1991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number7799
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7919
License Number StateNC

VIII. Authorized Official

Name: MISS AMANDA N GROESCHEL
Title or Position: DIRECTOR
Credential:
Phone: 704-948-1111