Provider Demographics
NPI:1902067648
Name:STONE, REID ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:REID
Middle Name:ALAN
Last Name:STONE
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 1:82 DUNMIRE DR
Mailing Address - Street 2:#2
Mailing Address - City:LEAD
Mailing Address - State:SD
Mailing Address - Zip Code:57754-1012
Mailing Address - Country:US
Mailing Address - Phone:605-584-2983
Mailing Address - Fax:
Practice Address - Street 1:425 W MAIN ST
Practice Address - Street 2:#2
Practice Address - City:LEAD
Practice Address - State:SD
Practice Address - Zip Code:57754-1644
Practice Address - Country:US
Practice Address - Phone:605-584-2983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD08231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice