Provider Demographics
NPI:1619632429
Name:RYAN J REID DMD PLLC
Entity Type:Organization
Organization Name:RYAN J REID DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:253-223-2580
Mailing Address - Street 1:1356 SINCLAIR DR
Mailing Address - Street 2:
Mailing Address - City:DUPONT
Mailing Address - State:WA
Mailing Address - Zip Code:98327-8815
Mailing Address - Country:US
Mailing Address - Phone:253-223-2580
Mailing Address - Fax:
Practice Address - Street 1:2727 HOLLYCROFT ST STE 280
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1305
Practice Address - Country:US
Practice Address - Phone:253-857-4114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-05
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty