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General NPI Number Information
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NPI Number | 1497940530
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Entity Type | Organization
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Legal Business Name | DONALD F. REYNOLDS, DDS, PC
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Dates
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Enumeration Date | 09/12/2007
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Last Update Date | 09/12/2007
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Provider Practice Location Address
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Address Line | 2000 HUNTINGTON AVE STE 107
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City | ALEXANDRIA
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State | VA
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Zip | 22303-1728
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Country | US
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Telephone | 703-960-8670
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Fax | 703-960-0267
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Provider Business Mailing Address
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Address Line | 2000 HUNTINGTON AVE STE 107
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City | ALEXANDRIA
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State | VA
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Zip | 22303-1728
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Country | US
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Telephone | 703-960-8670
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Fax | 703-960-0267
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DONALD FLOYD REYNOLDS
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Credential | DDS
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Telephone | 703-960-8670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3417
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License Number State | VA
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