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Individual

DR. ROBERT K REYNOLDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
3259 E SUNSHINE ST, SUITE Q, SPRINGFIELD, MO 65804-2143
(417) 881-3220
(417) 881-6473
Mailing address
3259 E SUNSHINE ST, SUITE Q, SPRINGFIELD, MO 65804-2143
(417) 881-3220
(417) 881-6473

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
015036
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
015036
DENTAL LICENSE
MO
Enumeration date
01/04/2007
Last updated
01/22/2014
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