Provider Demographics
NPI:1417398637
Name:REED, JAMES DAVIS (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DAVIS
Last Name:REED
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4240 BALMORAL DR SW
Mailing Address - Street 2:SUITE #200
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-6440
Mailing Address - Country:US
Mailing Address - Phone:256-852-9878
Mailing Address - Fax:256-852-9878
Practice Address - Street 1:4240 BALMORAL DR SW
Practice Address - Street 2:SUITE #200
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-6440
Practice Address - Country:US
Practice Address - Phone:256-852-9878
Practice Address - Fax:256-852-9878
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6028122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist