# DR. TIMOTHY REILLY DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558968743
- **Authorized official:** DR. TIMOTHY PHILLIP REILLY DDS (PRESIDENT)
- **Authorized official phone:** (248) 642-4484

## Contact information

- **Practice address:** 6405 TELEGRAPH RD BLDG C, BLOOMFIELD HILLS, MI 48301-1716
- **Practice address phone:** (248) 642-4484
- **Practice address fax:** (248) 885-8704
- **Mailing address:** 6405 TELEGRAPH RD BLDG C, BLOOMFIELD HILLS, MI 48301-1716
- **Mailing address phone:** (248) 642-4484
- **Mailing address fax:** (248) 885-8704

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/01/2020
- **Last updated:** 10/01/2020