Organization
BRUCE K. REEDER, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELE L. SPENCER (OFFICE MANAGER)
(580) 248-7600
Entity
Organization
Contact information
Practice address
5108 W GORE BLVD, SUITE 4, LAWTON, OK 73505-6025
(580) 248-7600
(580) 248-7633
Mailing address
5108 W GORE BLVD, SUITE 4, LAWTON, OK 73505-6025
(580) 248-7600
(580) 248-7633
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881725398
TYPE I NPI
—
Enumeration date
10/09/2007
Last updated
10/09/2007
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