Individual
DR. RANDY REASCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2121 WEST RESERVATION LOOP ROAD, CAMP VERDE, AZ 86322-8412
(928) 567-2168
Mailing address
PO BOX 31001-0698, PASADENA, CA 91110-0698
(602) 263-1200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4431
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
153875
—
AZ
Enumeration date
01/29/2007
Last updated
07/21/2022
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