Provider Demographics
NPI:1932628930
Name:MARK A REECE, DDS, LLC
Entity type:Organization
Organization Name:MARK A REECE, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:A
Authorized Official - Last Name:REECE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:256-259-1831
Mailing Address - Street 1:416 E LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768-1953
Mailing Address - Country:US
Mailing Address - Phone:256-259-1831
Mailing Address - Fax:256-259-0237
Practice Address - Street 1:416 E LAUREL ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-1953
Practice Address - Country:US
Practice Address - Phone:256-259-1831
Practice Address - Fax:256-259-0237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4319261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental