Organization
KIDS DENTAL CENTER, GP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAIN REYNOLDS DDS (OWNER/DENTIST)
(423) 458-4147
Entity
Organization
Contact information
Practice address
1805 KEITH ST NW, CLEVELAND, TN 37311-4306
(423) 458-4147
(423) 458-4148
Mailing address
1805 KEITH ST NW, CLEVELAND, TN 37311-4306
(423) 458-4147
(423) 458-4148
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
04/13/2021
Last updated
04/29/2026
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