Individual
DR. ROBERT NICHOLAS REYNOLDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
4744 S FLORIDA AVE, LAKELAND, FL 33813-2181
(617) 824-0253
Mailing address
502 S FREMONT AVE, APT #522, TAMPA, FL 33606-2068
(617) 824-0253
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D19672
FL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D19672
FL
Other
Enumeration date
07/28/2013
Last updated
08/05/2015
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