Organization
MARK A RIESE DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A RIESE DDS (DENTIST/OWNER)
(574) 583-5042
Entity
Organization
Contact information
Practice address
401 W BROADWAY ST, MONTICELLO, IN 47960-2004
(574) 583-5042
Mailing address
401 W BROADWAY ST, MONTICELLO, IN 47960-2004
(574) 583-5042
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/04/2023
Last updated
05/04/2023
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