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General NPI Number Information
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NPI Number | 1811151640
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Entity Type | Individual
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Provider Name | REED ATTISHA DMD, MD
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Gender | Male
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Dates
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Enumeration Date | 07/10/2008
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 163 SOUTH BELLEW AVENUE
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City | WATERTOWN
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State | NY
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Zip | 13601
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Country | US
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Telephone | 315-786-3990
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Fax | 316-786-3991
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Provider Business Mailing Address
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Address Line | 163 SOUTH BELLEW AVENUE
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City | WATERTOWN
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State | NY
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Zip | 13601
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Country | US
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Telephone | 315-786-3990
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Fax | 316-786-3991
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 50-056674
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License Number State | NY
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