Individual
JERRY HAROLD REITZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3480 CHESNEE HIGHWAY, CHESNEE, SC 29323
(864) 578-9940
(864) 578-0539
Mailing address
PO BOX 860, MAYO, SC 29368-0860
(864) 578-9040
(864) 578-0539
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2594
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZ2594
—
SC
Enumeration date
07/26/2006
Last updated
07/08/2007
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