Individual
MRS. ASIA REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
1502 E 63RD ST, CHICAGO, IL 60637-2921
(773) 496-5138
Mailing address
8056 S KINGSTON AVE, APT. 1E, CHICAGO, IL 60617-1293
(225) 279-1040
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020012291
IL
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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