Provider Demographics
NPI:1164406054
Name:REED, R R (DDS)
Entity Type:Individual
Prefix:
First Name:R
Middle Name:R
Last Name:REED
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 STATE FARM RD
Mailing Address - Street 2:SUITE 103 B
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4861
Mailing Address - Country:US
Mailing Address - Phone:828-268-9797
Mailing Address - Fax:828-265-7888
Practice Address - Street 1:870 STATE FARM RD
Practice Address - Street 2:SUITE 103 B
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4861
Practice Address - Country:US
Practice Address - Phone:828-268-9797
Practice Address - Fax:828-265-7888
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-04
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC89061223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics