Individual
MARK ANTHONY RIENECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6 MEDICAL DR, PORT JEFFERSON STATION, NY 11776-1594
(631) 928-2655
(631) 476-4635
Mailing address
6 MEDICAL DR, PORT JEFFERSON STATION, NY 11776-1594
(631) 928-2655
(631) 476-4635
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
046671
NY
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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