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General NPI Number Information
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NPI Number | 1962614479
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Entity Type | Organization
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Legal Business Name | JAMES J. REINERSMAN D.M.D. P.C.
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/25/2016
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Provider Practice Location Address
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Address Line | 2524 STATE ST
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City | ALTON
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State | IL
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Zip | 62002-5148
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Country | US
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Telephone | 618-462-2607
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Fax | 618-462-2607
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Provider Business Mailing Address
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Address Line | 2524 STATE ST
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City | ALTON
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State | IL
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Zip | 62002-5148
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Country | US
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Telephone | 618-466-4717
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Fax | 618-462-2607
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Authorized Official
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Title or Position | PRESIDENT-OWNER
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Name | DR. JAMES JOSEPH REINERSMAN
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Credential | D.M.D.
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Telephone | 618-462-2607
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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 | 019-015837
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License Number State | IL
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