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Individual

DR. DERRICK REID

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
54310 MYSTIQUE CT, MISHAWAKA, IN 46545-1824
(615) 327-9400
Mailing address
54310 MYSTIQUE CT, MISHAWAKA, IN 46545-1824
(615) 327-9400

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12012614A
IN
1223G0001X
General Practice Dentistry
8159
TN

Other

Enumeration date
02/28/2007
Last updated
11/27/2023
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