Reynolds, Edward

Reynolds, Edward is an individual health care provider with primary practice located at 47 Town St , Norwich CT 06360-2315. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Dental Providers / General Practice. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Reynolds, Edward can be contacted via phone (860) 892-7042.

Contact Information

Primary practice address
47 Town St Norwich CT 06360-2315
Phone: (860) 892-7042
Fax: (860) 823-3060
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 4544 Connecticut
Dental Providers / General Practice 1223G0001X 04544 Connecticut

Profile Details

NPI number 1528076593
LBN Legal business name Reynolds, Edward
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2006
Last updated Sep 16th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528076593 NPPES
Connecticut MEDICAID 008032342

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