Provider Demographics
NPI:1881725398
Name:REEDER, BRUCE K (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:K
Last Name:REEDER
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:5108 W GORE BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-6025
Mailing Address - Country:US
Mailing Address - Phone:580-248-7600
Mailing Address - Fax:580-248-7633
Practice Address - Street 1:5108 W GORE BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6025
Practice Address - Country:US
Practice Address - Phone:580-248-7600
Practice Address - Fax:580-248-7633
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK51241223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics