Provider Demographics
NPI:1386777159
Name:REEVES, ALLISON ANTOINETTE (DMD)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:ANTOINETTE
Last Name:REEVES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3789
Mailing Address - Street 2:516 WEST LIBERTY STREET
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4819
Mailing Address - Country:US
Mailing Address - Phone:803-773-9300
Mailing Address - Fax:803-773-3556
Practice Address - Street 1:516 WEST LIBERTY STREET
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4819
Practice Address - Country:US
Practice Address - Phone:803-773-9300
Practice Address - Fax:803-773-3556
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3346122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist