Individual
MICHAEL JOSEPH REIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
423 WATERFALL DR, ELKHART, IN 46516-3660
(574) 522-8578
Mailing address
51281 ASHLEY DR, GRANGER, IN 46530-8841
(219) 363-9838
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12012309A
IN
Other
Enumeration date
05/27/2015
Last updated
05/27/2015
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