MEDICARE: DR. TRUVELLA SHAREEN REESE D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	5577	NV

General Provider Information

NPI Number	:	1083803241
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TRUVELLA SHAREEN REESE D.M.D

Provider Business Mailing Address
First Line	:	4729 VINCENT HILL CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-2572
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4729 VINCENT HILL CT
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-2572
Country	:	US
Telephone Number	:	702-433-7708
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2007
Last Update Date	:	12/03/2007

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