Provider Demographics
NPI:1447331566
Name:REED, PAUL WILLIAM (DDS MS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:WILLIAM
Last Name:REED
Suffix:
Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:414 PETOSKEY ST
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2618
Mailing Address - Country:US
Mailing Address - Phone:231-347-4145
Mailing Address - Fax:231-347-9760
Practice Address - Street 1:414 PETOSKEY ST
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2618
Practice Address - Country:US
Practice Address - Phone:231-347-4145
Practice Address - Fax:231-347-9760
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI0163021223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics