Provider Demographics
NPI:1386862795
Name:REID W. MONTINI, D.M.D., M.S., P.A.
Entity Type:Organization
Organization Name:REID W. MONTINI, D.M.D., M.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:REID
Authorized Official - Middle Name:WALLACE
Authorized Official - Last Name:MONTINI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS, PA
Authorized Official - Phone:352-284-2915
Mailing Address - Street 1:7520 W UNIVERSITY AVE STE C
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32607-7612
Mailing Address - Country:US
Mailing Address - Phone:352-332-7911
Mailing Address - Fax:352-332-7910
Practice Address - Street 1:7520 W UNIVERSITY AVE STE C
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-7612
Practice Address - Country:US
Practice Address - Phone:352-332-7911
Practice Address - Fax:352-332-7910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN167901223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty