Provider Demographics
NPI:1366587917
Name:BIRNIE, REED L (DDS,PC)
Entity type:Individual
Prefix:DR
First Name:REED
Middle Name:L
Last Name:BIRNIE
Suffix:
Gender:M
Credentials:DDS,PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3602 BEECHER RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48503-4906
Mailing Address - Country:US
Mailing Address - Phone:810-233-6661
Mailing Address - Fax:810-233-6820
Practice Address - Street 1:3602 BEECHER RD
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48503-4906
Practice Address - Country:US
Practice Address - Phone:810-233-6661
Practice Address - Fax:810-233-6820
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI93961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice