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General NPI Number Information
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NPI Number | 1376349902
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Entity Type | Organization
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Legal Business Name | BRYAN REEDER DMD PLLC
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 222 S SUMMIT AVE STE 4
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City | PRESCOTT
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State | AZ
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Zip | 86303-3780
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Country | US
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Telephone | 928-445-0582
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Fax | 928-445-0974
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Provider Business Mailing Address
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Address Line | 222 S SUMMIT AVE STE 4
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City | PRESCOTT
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State | AZ
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Zip | 86303-3780
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Country | US
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Telephone | 928-445-0582
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Fax | 928-445-0974
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Authorized Official
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Title or Position | OWNER
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Name | BRYAN REEDER
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Credential | DMD
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Telephone | 928-445-0582
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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