Reynolds, Dale S

Reynolds, Dale S is an individual health care provider with primary practice located at 2330 Troop Dr Suite 104, Sartell MN 56377-4530. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Reynolds, Dale S can be contacted via phone (320) 230-8555.

Contact Information

Primary practice address
2330 Troop Dr Suite 104 Sartell MN 56377-4530
Phone: (320) 230-8555
Fax: (320) 230-8556
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 45473 Minnesota

Profile Details

NPI number 1578531364
LBN Legal business name Reynolds, Dale S
Credentials M.D. PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 9th, 2006
Last updated May 6th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578531364 NPPES
Minnesota Other 569S2CE BLUE CROSEE BLUE SHIELD
Minnesota MEDICAID 80793200 BLUE CROSEE BLUE SHIELD

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