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General NPI Number Information
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NPI Number | 1467716332
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Entity Type | Organization
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Legal Business Name | WILLIAM R REEVES, JR DDS PC
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Dates
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Enumeration Date | 06/26/2012
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Last Update Date | 06/26/2012
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Provider Practice Location Address
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Address Line | 2613 E HIGHWAY 377 STE 101
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City | GRANBURY
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State | TX
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Zip | 76049-6129
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Country | US
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Telephone | 817-573-8383
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Fax | 817-573-8484
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Provider Business Mailing Address
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Address Line | 2613 E HIGHWAY 377 STE 101
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City | GRANBURY
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State | TX
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Zip | 76049-6129
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Country | US
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Telephone | 817-573-8383
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Fax | 817-573-8484
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WILLIAM RUDYARD REEVES JR.
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Credential | DDS
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Telephone | 817-573-8383
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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 | 19019
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License Number State | TX
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