Individual
DR. JACK HOLMES REID JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
911 PLANTATION BLVD, FAIRHOPE, AL 36532-2949
(251) 928-9331
Mailing address
911 PLANTATION BLVD, FAIRHOPE, AL 36532-2949
(251) 928-9331
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
3625
AL
Other
Enumeration date
10/01/2007
Last updated
10/01/2007
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