Provider Demographics
NPI:1790856987
Name:REESE, JAMES D (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:REESE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1876 BUTLER PIKE
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1201
Mailing Address - Country:US
Mailing Address - Phone:610-825-1858
Mailing Address - Fax:610-825-0722
Practice Address - Street 1:1876 BUTLER PIKE
Practice Address - Street 2:
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-1201
Practice Address - Country:US
Practice Address - Phone:610-825-1858
Practice Address - Fax:610-825-0722
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-022525-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice