Healthcare Provider Details

I. General information

NPI: 1982846846
Provider Name (Legal Business Name): DAVID M REEVES D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2009
Last Update Date: 03/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5420 KIETZKE LN SUITE 100
RENO NV
89511-3022
US

IV. Provider business mailing address

5420 KIETZKE LN SUITE 100
RENO NV
89511-3022
US

V. Phone/Fax

Practice location:
  • Phone: 775-825-5221
  • Fax: 775-823-9824
Mailing address:
  • Phone: 775-825-5221
  • Fax: 775-823-9824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number2864
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: