Provider Demographics
NPI:1194816173
Name:REED, CHARLES F (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:F
Last Name:REED
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7907 S QUEMOY WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-7211
Mailing Address - Country:US
Mailing Address - Phone:303-929-0210
Mailing Address - Fax:
Practice Address - Street 1:7890 E FLORENTINE RD
Practice Address - Street 2:
Practice Address - City:PRESCOTT VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86314-1204
Practice Address - Country:US
Practice Address - Phone:928-350-8869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1055921223X0400X
AZ037071223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics