Provider Demographics
NPI:1962006767
Name:REID, CHELSEA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:
Last Name:REID
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1593 PUCKER ST
Mailing Address - Street 2:
Mailing Address - City:STOWE
Mailing Address - State:VT
Mailing Address - Zip Code:05672-4579
Mailing Address - Country:US
Mailing Address - Phone:802-253-4157
Mailing Address - Fax:
Practice Address - Street 1:1593 PUCKER ST
Practice Address - Street 2:
Practice Address - City:STOWE
Practice Address - State:VT
Practice Address - Zip Code:05672-4579
Practice Address - Country:US
Practice Address - Phone:802-253-4157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016.01339591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice