Provider Demographics
NPI:1154482990
Name:REEDER, BILLIE THOMPSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:BILLIE
Middle Name:THOMPSON
Last Name:REEDER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 W WILL ROGERS BLVD
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-6825
Mailing Address - Country:US
Mailing Address - Phone:918-343-4300
Mailing Address - Fax:918-342-4697
Practice Address - Street 1:600 W WILL ROGERS BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-6825
Practice Address - Country:US
Practice Address - Phone:918-343-4300
Practice Address - Fax:918-342-4697
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5123122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist