MEDICARE: DR. ELIZABETH A REITER D D S LTD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	4058	NV

General Provider Information

NPI Number	:	1033262241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH A REITER D D S LTD

Provider Business Mailing Address
First Line	:	1825 VILLAGE CENTER CIR
Second Line	:	STE 150
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-0518
Country	:	US
Telephone Number	:	702-562-2400
Fax Number	:	702-447-4876

Provider Business Practice Location Address
First Line	:	1825 VILLAGE CENTER CIR
Second Line	:	STE 150
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-0518
Country	:	US
Telephone Number	:	702-562-2400
Fax Number	:	702-562-0011

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	03/17/2017

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