Provider Demographics
NPI:1720789746
Name:REYNOLDSBUR J&J DDS LLC
Entity Type:Organization
Organization Name:REYNOLDSBUR J&J DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:WILLARD
Authorized Official - Last Name:PAPP
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-264-8327
Mailing Address - Street 1:12323 STATE ROUTE 521
Mailing Address - Street 2:
Mailing Address - City:SUNBURY
Mailing Address - State:OH
Mailing Address - Zip Code:43074-9429
Mailing Address - Country:US
Mailing Address - Phone:614-264-8327
Mailing Address - Fax:
Practice Address - Street 1:7589 E MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-1291
Practice Address - Country:US
Practice Address - Phone:614-866-5518
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental