Provider Demographics
NPI:1497711741
Name:REID, JAMES BOWERS (DDS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:BOWERS
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 1:107 HILLSIDE ROAD
Mailing Address - Street 2:
Mailing Address - City:SO DEERFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01373
Mailing Address - Country:US
Mailing Address - Phone:413-665-2272
Mailing Address - Fax:413-665-9613
Practice Address - Street 1:4 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:SO DEERFIELD
Practice Address - State:MA
Practice Address - Zip Code:01373
Practice Address - Country:US
Practice Address - Phone:413-665-4575
Practice Address - Fax:413-665-9613
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA122641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice