MEDICARE: DR. LESTER C REID D.M.D.

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	1223E0200X	Endodontics	8631	CT

General Provider Information

NPI Number	:	1871937359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESTER C REID D.M.D.

Provider Business Mailing Address
First Line	:	225 N MAIN ST STE 209
Second Line	:
City	:	BRISTOL
State	:	CT
Zip	:	06010-4993
Country	:	US
Telephone Number	:	860-583-8379
Fax Number	:	860-589-0788

Provider Business Practice Location Address
First Line	:	225 N MAIN ST STE 209
Second Line	:
City	:	BRISTOL
State	:	CT
Zip	:	06010-4993
Country	:	US
Telephone Number	:	860-583-8379
Fax Number	:	860-589-0788

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

Provider Enumeration Date	:	04/26/2013
Last Update Date	:	07/10/2020

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