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Individual

THOMAS ALAN REESE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
US HWY 491 NORTH, SHIPROCK, NM 87420
(505) 368-6401
(505) 368-6431
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6401
(505) 368-6431

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS025922L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
703753
AZ
05
99056551
CO
05
R5287
NM
Enumeration date
10/03/2005
Last updated
09/20/2007
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