Provider Demographics
NPI:1518228998
Name:REID, ROSS ALEXANDER (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:ALEXANDER
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 1:6215 NORMANDY DR
Mailing Address - Street 2:#10
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-7377
Mailing Address - Country:US
Mailing Address - Phone:248-342-5532
Mailing Address - Fax:
Practice Address - Street 1:427 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-4314
Practice Address - Country:US
Practice Address - Phone:989-755-0991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2012-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010206521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice