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General NPI Number Information
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NPI Number | 1245352285
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Entity Type | Organization
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Legal Business Name | K T REESE DDS A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 215 S 200 E
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City | TOOELE
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State | UT
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Zip | 84074-2714
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Country | US
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Telephone | 435-882-0685
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Fax | 435-882-8720
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Provider Business Mailing Address
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Address Line | 215 S 200 E
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City | TOOELE
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State | UT
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Zip | 84074-2714
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Country | US
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Telephone | 435-882-0685
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Fax | 435-882-8720
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KAY THOMAS REESE
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Credential | D.D.S.
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Telephone | 435-882-0685
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 129932-9922
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License Number State | UT
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