Organization
ROGER N REYNOLDS 111 DDS MS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER NIXON REYNOLDS III DDS (PRESIDENT)
(336) 768-9010
Entity
Organization
Contact information
Practice address
3809 FORRESTGATE DR, SUITE A, WINSTON SALEM, NC 27103-2982
(336) 768-9010
(336) 768-9011
Mailing address
3809 FORRESTGATE DR, SUITE A, WINSTON SALEM, NC 27103-2982
(336) 768-9010
(336) 768-9011
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3599
NC
Other
Enumeration date
05/20/2008
Last updated
05/20/2008
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