Provider Demographics
NPI:1881258192
Name:JOHN T. REED, DDS., INC.
Entity type:Organization
Organization Name:JOHN T. REED, DDS., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:MARQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-478-4322
Mailing Address - Street 1:2509 W MARCH LN STE 240
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-8223
Mailing Address - Country:US
Mailing Address - Phone:209-478-4322
Mailing Address - Fax:209-478-4117
Practice Address - Street 1:2509 W MARCH LN STE 240
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-8223
Practice Address - Country:US
Practice Address - Phone:209-478-4322
Practice Address - Fax:209-478-4117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental