Individual
DR. MICHAEL SEAN MCREYNOLDS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
711 BRIDGE ST, HUMBOLDT, KS 66748-1707
(620) 473-2289
(620) 473-3846
Mailing address
PO BOX 8, HUMBOLDT, KS 66748-0008
(620) 473-2289
(620) 473-3846
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6664
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
116529
BCBS PROVIDER NUMBER
KS
Enumeration date
05/30/2006
Last updated
07/08/2007
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