Reitzel, Jeffrey Damon

Reitzel, Jeffrey Damon is an individual health care provider with primary practice located at 200 5Th Ave 3Rd Floor, Waltham MA 02451-8779. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Reitzel, Jeffrey Damon can be contacted via phone (781) 647-0772.

Contact Information

Primary practice address
200 5Th Ave 3Rd Floor Waltham MA 02451-8779
Phone: (781) 647-0772
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 4214 South Carolina
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DN1855919 Massachusetts

Profile Details

NPI number 1871682906
LBN Legal business name Reitzel, Jeffrey Damon
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2006
Last updated Jul 6th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871682906 NPPES
South Carolina MEDICAID ZX4214

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