Provider Demographics
NPI:1568252336
Name:REYNOLDS, ANDREW JAMES JR (DMD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JAMES
Last Name:REYNOLDS
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 SPRING ST APT B
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-5677
Mailing Address - Country:US
Mailing Address - Phone:803-847-1016
Mailing Address - Fax:
Practice Address - Street 1:152 SPRING ST APT B
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5677
Practice Address - Country:US
Practice Address - Phone:803-847-1016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program