Individual
DALE S REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D. PH.D.
Contact information
Practice address
2330 TROOP DR, SUITE 104, SARTELL, MN 56377-4530
(320) 230-8555
(320) 230-8556
Mailing address
2330 TROOP DR, SUITE 104, SARTELL, MN 56377-4530
(320) 230-8555
(320) 230-8556
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
45473
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
569S2CE
BLUE CROSEE BLUE SHIELD
MN
05
—
80793200
—
MN
Enumeration date
03/09/2006
Last updated
05/06/2009
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