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Individual
DR. REENA THOMAS GEORGE
Active
Individual
DR. REENA THOMAS GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019025741
IL
122300000X
Dentist
23742
TX
1223G0001X
General Practice Dentistry
Primary
23742
TX
1223P0221X
Pediatric Dentistry
23742
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163346
—
IL
Enumeration date
10/19/2005
Last updated
07/22/2011
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