Provider Demographics
NPI:1194736876
Name:REYNOLDS DENTAL ASSOCIATES PA
Entity type:Organization
Organization Name:REYNOLDS DENTAL ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENDA
Authorized Official - Middle Name:CHARLENE
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-524-2224
Mailing Address - Street 1:24 CORPORATE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NH
Mailing Address - Zip Code:03220-3103
Mailing Address - Country:US
Mailing Address - Phone:603-524-2224
Mailing Address - Fax:603-524-5827
Practice Address - Street 1:24 CORPORATE DRIVE
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NH
Practice Address - Zip Code:03220-3103
Practice Address - Country:US
Practice Address - Phone:603-524-2224
Practice Address - Fax:603-524-5827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2637122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty