Provider Demographics
NPI:1508648460
Name:J.D. REED DENTAL, INC.
Entity Type:Organization
Organization Name:J.D. REED DENTAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/DR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:256-533-6006
Mailing Address - Street 1:314 BOB WALLACE AVE SW STE A
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3837
Mailing Address - Country:US
Mailing Address - Phone:256-533-6006
Mailing Address - Fax:256-533-6022
Practice Address - Street 1:314 BOB WALLACE AVE SW STE A
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3837
Practice Address - Country:US
Practice Address - Phone:256-533-6006
Practice Address - Fax:256-533-6022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-16
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental