Individual
DR. JEFFREY DAMON REITZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
200 5TH AVE, 3RD FLOOR, WALTHAM, MA 02451-8779
(781) 647-0772
Mailing address
200 5TH AVE, 3RD FLOOR, WALTHAM, MA 02451-8779
(781) 647-0772
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4214
SC
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN1855919
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX4214
—
SC
Enumeration date
10/12/2006
Last updated
07/06/2014
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