Provider Demographics
NPI:1972138774
Name:RICK REINECKER DMD
Entity type:Organization
Organization Name:RICK REINECKER DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:A
Authorized Official - Last Name:REINECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-484-0707
Mailing Address - Street 1:2726 N READING RD
Mailing Address - Street 2:
Mailing Address - City:REINHOLDS
Mailing Address - State:PA
Mailing Address - Zip Code:17569-9640
Mailing Address - Country:US
Mailing Address - Phone:717-484-0707
Mailing Address - Fax:
Practice Address - Street 1:2726 N READING RD
Practice Address - Street 2:
Practice Address - City:REINHOLDS
Practice Address - State:PA
Practice Address - Zip Code:17569-9640
Practice Address - Country:US
Practice Address - Phone:717-484-0707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103425071OtherPROMISE ID