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General NPI Number Information
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NPI Number | 1285780346
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Entity Type | Organization
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Legal Business Name | DOUGLAS G. REID, DDS, PC
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 232 E CACHE LA POUDRE ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80903-2903
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Country | US
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Telephone | 719-473-7441
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Fax | 719-632-7970
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Provider Business Mailing Address
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Address Line | 232 E CACHE LA POUDRE ST
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City | COLORADO SPRINGS
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State | CO
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Zip | 80903-2903
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Country | US
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Telephone | 719-473-7441
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Fax | 719-632-7970
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS GEORGE REID
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Credential | DDS
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Telephone | 719-473-7441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 104491
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License Number State | CO
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