MEDICARE: MICHAEL RHEES DMD

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	122300000X	Dentist	00204709	CO

General Provider Information

NPI Number	:	1598330391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL RHEES DMD

Provider Business Mailing Address
First Line	:	1258 INTERQUEST PKWY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-4183
Country	:	US
Telephone Number	:	719-484-0043
Fax Number	:

Provider Business Practice Location Address
First Line	:	1258 INTERQUEST PKWY
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-4183
Country	:	US
Telephone Number	:	719-484-0043
Fax Number	:

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

Provider Enumeration Date	:	05/24/2021
Last Update Date	:	05/24/2021

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