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General NPI Number Information
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NPI Number | 1437547486
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Entity Type | Organization
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Legal Business Name | ROBERT V. REZNICHEK DDS, A PROFESSIONAL CORP.
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Dates
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Enumeration Date | 12/29/2014
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Last Update Date | 12/29/2014
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Provider Practice Location Address
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Address Line | 135 E THIRD AVE SUITE A
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City | ESCONDIDO
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State | CA
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Zip | 92595-4252
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Country | US
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Telephone | 760-745-1831
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Fax | 760-745-3415
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Provider Business Mailing Address
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Address Line | 135 E THIRD AVE SUITE A
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City | ESCONDIDO
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State | CA
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Zip | 92595-4252
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Country | US
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Telephone | 760-745-1831
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Fax | 760-745-3415
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Authorized Official
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Title or Position | DENTIST-ORTHODONTIST
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Name | DR. ROBERT VICTOR REZNICHEK
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Credential | DDS
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Telephone | 760-745-1831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State | CA
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