Individual
NATHAN EDWARD RIECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
7686 W RIDGE RD, FAIRVIEW, PA 16415-1074
(814) 474-5022
(814) 474-5022
Mailing address
204 W PLUM ST, EDINBORO, PA 16412-6002
(814) 734-4451
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS041333
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437609260
—
PA
Enumeration date
10/05/2016
Last updated
06/11/2020
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