Provider Demographics
NPI:1679675789
Name:MURUGASU-REID, ANNE (DDS)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:MURUGASU-REID
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:REID
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1327 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-2542
Mailing Address - Country:US
Mailing Address - Phone:407-228-1353
Mailing Address - Fax:407-228-1394
Practice Address - Street 1:1327 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-2542
Practice Address - Country:US
Practice Address - Phone:407-228-1353
Practice Address - Fax:407-228-1394
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN165801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice