MEDICARE: DR. ROSS REITER D.M.D.

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	DN18832	FL

General Provider Information

NPI Number	:	1780816256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSS REITER D.M.D.

Provider Business Mailing Address
First Line	:	5739 CANTON CV
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-5079
Country	:	US
Telephone Number	:	407-669-9831
Fax Number	:

Provider Business Practice Location Address
First Line	:	5739 CANTON CV
Second Line	:
City	:	WINTER SPRINGS
State	:	FL
Zip	:	32708-5079
Country	:	US
Telephone Number	:	407-669-9831
Fax Number	:

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

Provider Enumeration Date	:	08/18/2009
Last Update Date	:	11/08/2010

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