Provider Demographics
NPI:1376771691
Name:REED, RUTH ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:RUTH
Middle Name:ANN
Last Name:REED
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MISS
Other - First Name:RUTH
Other - Middle Name:ANN
Other - Last Name:BOURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:125 BARNETT ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-1263
Mailing Address - Country:US
Mailing Address - Phone:606-679-6055
Mailing Address - Fax:606-451-9012
Practice Address - Street 1:125 BARNETT ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-1263
Practice Address - Country:US
Practice Address - Phone:606-679-6055
Practice Address - Fax:606-451-9012
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-25
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY8797122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist