| Reo Family Dental | |
|
3430 W State Road 66 Rockport IN 47635-9259 | |
| (812) 649-4416 | |
| (812) 649-2651 |
| Full Name | Reo Family Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3430 W State Road 66, Rockport, Indiana |
| Authorized Official Name and Position | Brittany Eirwin-maqueda (OWNER DENTIST) |
| Authorized Official Contact | 8126494416 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Reo Family Dental 3430 W State Road 66 Rockport IN 47635-9259 Ph: (812) 649-4416 | Reo Family Dental 3430 W State Road 66 Rockport IN 47635-9259 Ph: (812) 649-4416 |
| NPI Number | 1417407644 |
|---|---|
| Provider Enumeration Date | 10/12/2016 |
| Last Update Date | 10/13/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417407644 | NPI | - | NPPES |
| 201115460 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12011855A (Indiana) | Primary |