Provider Demographics
NPI:1386882751
Name:REEDSTROM, DEAN MICHAEL (DDS)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:MICHAEL
Last Name:REEDSTROM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 10001
Mailing Address - Street 2:PMB 807
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950
Mailing Address - Country:US
Mailing Address - Phone:670-233-1100
Mailing Address - Fax:670-233-2233
Practice Address - Street 1:MIDDLE ROAD
Practice Address - Street 2:BLK. 2 GROUND FLOOR D'TORRES BLDG. DENTAL CARE CLINIC
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950
Practice Address - Country:US
Practice Address - Phone:670-233-1100
Practice Address - Fax:670-233-2233
Is Sole Proprietor?:No
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MP0063122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist