MEDICARE: DR. DAVID MAURICE REID D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	042252	NY

General Provider Information

NPI Number	:	1063651107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID MAURICE REID D.D.S.

Provider Business Mailing Address
First Line	:	21902 LINDEN BLVD
Second Line	:
City	:	CAMBRIA HEIGHTS
State	:	NY
Zip	:	11411-1619
Country	:	US
Telephone Number	:	718-978-5938
Fax Number	:	718-297-1930

Provider Business Practice Location Address
First Line	:	21902 LINDEN BLVD
Second Line	:
City	:	CAMBRIA HEIGHTS
State	:	NY
Zip	:	11411-1619
Country	:	US
Telephone Number	:	718-978-5938
Fax Number	:	718-297-1930

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2009
Last Update Date	:	02/12/2009

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