Individual
DR. TIMOTHY M REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5978 HARVEY ST, MUSKEGON, MI 49444-9737
(231) 799-0404
(231) 799-0014
Mailing address
5978 HARVEY ST, MUSKEGON, MI 49444-9737
(231) 799-0404
(231) 799-0014
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
15138
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1929192
—
MI
01
—
J801835
MICHIGAN BCBS DENTAL
MI
Enumeration date
11/30/2006
Last updated
07/09/2007
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