Provider Demographics
NPI:1316787963
Name:REYES, RILEY CHASE (DMD)
Entity type:Individual
Prefix:DR
First Name:RILEY
Middle Name:CHASE
Last Name:REYES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49319-7505
Mailing Address - Country:US
Mailing Address - Phone:616-696-9420
Mailing Address - Fax:616-696-9420
Practice Address - Street 1:20 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:CEDAR SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49319-7505
Practice Address - Country:US
Practice Address - Phone:616-696-9420
Practice Address - Fax:616-696-8272
Is Sole Proprietor?:No
Enumeration Date:2024-05-30
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901602174122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist