Provider Demographics
NPI:1770631442
Name:MCREYNOLDS, DAVID C (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:MCREYNOLDS
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:1135 KELLER PKWY
Mailing Address - Street 2:BUILDING 1
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3614
Mailing Address - Country:US
Mailing Address - Phone:817-431-0683
Mailing Address - Fax:817-431-8406
Practice Address - Street 1:1135 KELLER PKWY
Practice Address - Street 2:BUILDING 1
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3614
Practice Address - Country:US
Practice Address - Phone:817-431-0683
Practice Address - Fax:817-431-8406
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX154351223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics