Provider Demographics
NPI:1346469079
Name:REED, ERIC H (DDS, MD)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:H
Last Name:REED
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1459 RIDGE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4211
Mailing Address - Country:US
Mailing Address - Phone:239-263-7474
Mailing Address - Fax:239-263-2528
Practice Address - Street 1:1459 RIDGE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4211
Practice Address - Country:US
Practice Address - Phone:239-263-7474
Practice Address - Fax:239-263-2528
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN137781223S0112X
FLME71048174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Not Answered174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
69749AMedicare ID - Type Unspecified
G36098Medicare UPIN