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General NPI Number Information
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NPI Number | 1275939944
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Entity Type | Individual
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Provider Name | RONALD IVAN REITER D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/07/2014
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Last Update Date | 11/07/2014
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Provider Practice Location Address
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Address Line | 5000 W TILGHMAN ST SUITE 240
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City | ALLENTOWN
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State | PA
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Zip | 18104-9109
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Country | US
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Telephone | 610-395-4044
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Fax | 610-395-5693
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Provider Business Mailing Address
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Address Line | 63 HIGHLAND DR
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City | FLEETWOOD
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State | PA
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Zip | 19522-9615
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Country | US
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Telephone | 610-223-0503
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Fax | 610-987-0668
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DSO20913L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number | DA020913A
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License Number State | PA
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