Provider Demographics
NPI:1699968156
Name:REICHERT, HUBBLE VAUGHN (DDS)
Entity type:Individual
Prefix:DR
First Name:HUBBLE
Middle Name:VAUGHN
Last Name:REICHERT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11812 STANDING STONE DR
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:NE
Mailing Address - Zip Code:68028-7979
Mailing Address - Country:US
Mailing Address - Phone:402-905-2880
Mailing Address - Fax:402-905-2550
Practice Address - Street 1:11812 STANDING STONE DR
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:NE
Practice Address - Zip Code:68028-7979
Practice Address - Country:US
Practice Address - Phone:402-905-2880
Practice Address - Fax:402-905-2550
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-19
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6679122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist