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Organization
REYNOLDS DENTAL CLINIC P.A.
Active
Organization
REYNOLDS DENTAL CLINIC P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHI T LE D.D.S. (OWNER)
(817) 656-4656
Entity
Organization
Contact information
Practice address
6242 RUFE SNOW DR, SUITE 220, FORT WORTH, TX 76148-3340
(817) 656-4656
Mailing address
6242 RUFE SNOW DR, SUITE 220, FORT WORTH, TX 76148-3340
(817) 656-4656
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
20159
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152674102
—
TX
05
—
205029601
—
TX
Enumeration date
09/14/2010
Last updated
02/15/2012
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