Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 1159 | NH |
Y | 213EG0000X | General Practice | 1159 | NH |
N | 1223P0700X | Prosthodontist | 1159 | NH |
NPI | 1023250057 |
---|---|
Provider Name | Dr. John Standish Reever |
First Address | Plymouth, NH 03264-1128 |
Second Address | Plymouth, NH 03264-1128 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2009 |
Last Update Date | 06/04/2009 |