Individual
BRADLEY G REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
114 E BROOKWOOD ROAD, MIDFIELD, AL 35228
(205) 923-6828
(205) 923-1680
Mailing address
58 PALEO PL, INDIAN SPRINGS, AL 35124-3724
(205) 995-2027
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4980
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51504362REY
BLUE CROSS AND BLUE SHIEL
AL
Enumeration date
11/24/2006
Last updated
07/08/2007
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