Reese, Shawn E

Reese, Shawn E is an individual health care provider with primary practice located at 3434 Kimball Avenue , Waterloo IA 50702. He recently has only one registered license in Dental Providers / Periodontics, which is considered as his primary health care specialty. Reese, Shawn E can be contacted via phone (319) 236-0861.

Contact Information

Primary practice address
3434 Kimball Avenue Waterloo IA 50702
Fax: (319) 236-0410
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Periodontics 1223P0300X 08003 Iowa

Profile Details

NPI number 1700971538
LBN Legal business name Reese, Shawn E
Credentials DDS MS PC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700971538 NPPES
Iowa MEDICAID 0200550
Iowa Other 23960
Iowa Other 64004970

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