Provider Demographics
NPI:1639507049
Name:HOWARD E REARDEN, DMD, PC
Entity Type:Organization
Organization Name:HOWARD E REARDEN, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:REARDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-745-3563
Mailing Address - Street 1:111 N 16TH ST
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5655
Mailing Address - Country:US
Mailing Address - Phone:334-745-3563
Mailing Address - Fax:334-745-3566
Practice Address - Street 1:111 N 16TH ST
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5655
Practice Address - Country:US
Practice Address - Phone:334-745-3563
Practice Address - Fax:334-745-3566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-22
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental