Individual
DR. JACK J. REYNOLDS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1002 OAK DR, RICHMOND, IN 47374-1916
(765) 966-7602
(765) 962-1066
Mailing address
1002 OAK DR, RICHMOND, IN 47374-1916
(765) 966-7602
(765) 962-1066
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
12007171A
IN
Other
Enumeration date
10/13/2006
Last updated
07/08/2007
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