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1003974080
KENNETH BRADLEY REYNOLDS
PORTSMOUTH, VA
NPI
1003974080
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: VA VA6170)
Enumeration Date
2006-12-04
Last Update Date
2007-07-08
Business Address
Dr. KENNETH BRADLEY REYNOLDS D.D.S
1307 AIRLINE BLVD
PORTSMOUTH, VA 23707-4011
Phone number: 757-399-4662
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Mailing Address
Dr. KENNETH BRADLEY REYNOLDS D.D.S
788 LOS COLONIS DR
VIRGINIA BEACH, VA 23456-6411
Phone number: 757-477-5051
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