Provider Demographics
NPI:1245396928
Name:REID, RICHARD BENTLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BENTLEY
Last Name:REID
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 1:685 BLYTHE STREET CT STE B
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4167
Mailing Address - Country:US
Mailing Address - Phone:828-696-2245
Mailing Address - Fax:828-696-2022
Practice Address - Street 1:685 BLYTHE STREET CT STE B
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4167
Practice Address - Country:US
Practice Address - Phone:828-696-2245
Practice Address - Fax:828-696-2022
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC68681223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89902VHMedicaid