Provider Demographics
NPI:1184770828
Name:STEVEN C REYNOLDS D.D.S, P.C.
Entity type:Organization
Organization Name:STEVEN C REYNOLDS D.D.S, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-652-1010
Mailing Address - Street 1:600 N MAIN ST
Mailing Address - Street 2:STE 100
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48307-1426
Mailing Address - Country:US
Mailing Address - Phone:248-652-1010
Mailing Address - Fax:248-652-7005
Practice Address - Street 1:600 N MAIN ST
Practice Address - Street 2:STE 100
Practice Address - City:ROCHESTER
Practice Address - State:MI
Practice Address - Zip Code:48307-1426
Practice Address - Country:US
Practice Address - Phone:248-652-1010
Practice Address - Fax:248-652-7005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty