Healthcare Provider Details

I. General information

NPI: 1184734238
Provider Name (Legal Business Name): DAVID H REISS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3554 HULMEVILLE RD SUITE 110
BENSALEM PA
19020
US

IV. Provider business mailing address

64 PURCHMENTDRIVE
NEW HOPE PA
18938
US

V. Phone/Fax

Practice location:
  • Phone: 215-244-9505
  • Fax:
Mailing address:
  • Phone: 215-244-9505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDS022193L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: