Individual
AMY L REIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
1155 CANTERBURY ST, CRESCO, IA 52136
(563) 547-1704
(563) 547-1111
Mailing address
1155 CANTERBURY ST, CRESCO, IA 52136
(563) 547-1704
(563) 547-1111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08604
IA
122300000X
Dentist
6148-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33813700
—
WI
Enumeration date
02/10/2009
Last updated
05/28/2009
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