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General NPI Number Information
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NPI Number | 1629470380
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Entity Type | Organization
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Legal Business Name | RIEHS PEDIATRIC DENTAL PC
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Dates
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Enumeration Date | 09/24/2014
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Last Update Date | 09/24/2014
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Provider Practice Location Address
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Address Line | 8335 WESTCHESTER DRIVE SUITE 152
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City | DALLAS
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State | TX
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Zip | 75225-5718
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Country | US
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Telephone | 214-244-4159
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Fax | 214-871-7110
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Provider Business Mailing Address
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Address Line | 9440 MONTELEON CT
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City | DALLAS
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State | TX
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Zip | 75220-5869
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Country | US
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Telephone | 214-244-4159
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Fax | 214-871-7110
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN JACOB RIEHS
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Credential | DDS
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Telephone | 214-244-4159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 20806
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License Number State | TX
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