Healthcare Provider Details

I. General information

NPI: 1396123683
Provider Name (Legal Business Name): REEVES, D.D.S. AND LAVALLEY, D.D.S., A DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2015
Last Update Date: 02/09/2023
Certification Date: 02/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1791 OAK AVE STE C
DAVIS CA
95616-1073
US

IV. Provider business mailing address

3100 ZINFANDEL DR STE 400
RANCHO CORDOVA CA
95670-6391
US

V. Phone/Fax

Practice location:
  • Phone: 530-756-7516
  • Fax: 530-756-0727
Mailing address:
  • Phone: 916-570-1500
  • Fax: 530-756-0727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: AARON REEVES
Title or Position: OWNER
Credential:
Phone: 530-756-7516