Provider Demographics
NPI:1669548251
Name:CARTER C REESE DDS LTD
Entity type:Organization
Organization Name:CARTER C REESE DDS LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:JACOBSON
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:763-544-8745
Mailing Address - Street 1:9401 36TH AVE N
Mailing Address - Street 2:
Mailing Address - City:NEW HOPE
Mailing Address - State:MN
Mailing Address - Zip Code:55427
Mailing Address - Country:US
Mailing Address - Phone:763-544-8745
Mailing Address - Fax:763-544-9702
Practice Address - Street 1:9401 36TH AVE N
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:MN
Practice Address - Zip Code:55427
Practice Address - Country:US
Practice Address - Phone:763-544-8745
Practice Address - Fax:763-544-9702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty