Provider Demographics
NPI:1295084838
Name:DYER, CELIA REED (DMD)
Entity type:Individual
Prefix:DR
First Name:CELIA
Middle Name:REED
Last Name:DYER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:CELIA
Other - Middle Name:ANN
Other - Last Name:BIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 53073
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30355-1073
Mailing Address - Country:US
Mailing Address - Phone:404-444-8115
Mailing Address - Fax:
Practice Address - Street 1:290 HILDERBRAND DR NE
Practice Address - Street 2:SUITE A-9
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3906
Practice Address - Country:US
Practice Address - Phone:404-255-2273
Practice Address - Fax:404-255-0923
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0121311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice