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General NPI Number Information
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NPI Number | 1285061325
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Entity Type | Organization
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Legal Business Name | MARK A REBER, DDS. MS, INC.
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Dates
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Enumeration Date | 10/03/2013
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Last Update Date | 10/03/2013
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Provider Practice Location Address
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Address Line | 1049 COCHRANE RD #110
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City | MORGAN HILL
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State | CA
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Zip | 95037-9077
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Country | US
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Telephone | 408-778-4440
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Fax | 408-778-8338
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Provider Business Mailing Address
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Address Line | 1049 COCHRANE ROAD SUITE 110
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City | MORGAN HILL
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State | CA
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Zip | 95037
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Country | US
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Telephone | 408-778-4440
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Fax | 408-778-8338
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Authorized Official
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Title or Position | CEO
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Name | MARK ALAN REBER
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Credential | D.D.S.
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Telephone | 408-778-4440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 57637
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 33652
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License Number State | CA
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