| Tim Rieke DDS LLC | |
|
1312 Southwest Blvd Jefferson City MO 65109 | |
| (573) 634-3115 | |
| (573) 634-2381 |
| Full Name | Tim Rieke DDS LLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1312 Southwest Blvd, Jefferson City, Missouri |
| Authorized Official Name and Position | Tim J Rieke (MEMBER) |
| Authorized Official Contact | 5736343115 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tim Rieke DDS LLC 1312 Southwest Blvd Jefferson City MO 65109 Ph: (573) 634-3115 | Tim Rieke DDS LLC 1312 Southwest Blvd Jefferson City MO 65109 Ph: (573) 634-3115 |
| NPI Number | 1295917110 |
|---|---|
| Provider Enumeration Date | 12/03/2007 |
| Last Update Date | 12/03/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295917110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 013681 (Missouri) | Primary |
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