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General NPI Number Information
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NPI Number | 1184881963
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Entity Type | Organization
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Legal Business Name | ADRIAN P REHAK, DDS, PC
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 4015 MOUNT VERNON RD SE
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City | CEDAR RAPIDS
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State | IA
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Zip | 52403-3891
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Country | US
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Telephone | 319-362-3179
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Fax | 319-362-9586
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Provider Business Mailing Address
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Address Line | 4015 MOUNT VERNON RD SE
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City | CEDAR RAPIDS
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State | IA
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Zip | 52403-3891
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Country | US
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Telephone | 319-362-3179
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Fax | 319-362-9586
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | ADRIAN P REHAK
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Credential | DDS
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Telephone | 319-362-3179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 6205
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License Number State | IA
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