Provider Demographics
NPI:1841276771
Name:REYNOLDS, HILARY A (DDS)
Entity type:Individual
Prefix:
First Name:HILARY
Middle Name:A
Last Name:REYNOLDS
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 1:320 N 3RD ST
Mailing Address - Street 2:SUITE 516
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-5304
Mailing Address - Country:US
Mailing Address - Phone:319-752-5540
Mailing Address - Fax:
Practice Address - Street 1:320 N 3RD ST
Practice Address - Street 2:SUITE 516
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-5304
Practice Address - Country:US
Practice Address - Phone:319-752-5540
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA081861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0288191Medicaid
IL1005590Medicaid
IA33773OtherWELLMARK BCBS