Provider Demographics
NPI:1396123683
Name:REEVES, D.D.S. AND LAVALLEY, D.D.S., A DENTAL CORPORATION
Entity type:Organization
Organization Name:REEVES, D.D.S. AND LAVALLEY, D.D.S., A DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-756-7516
Mailing Address - Street 1:3100 ZINFANDEL DR STE 400
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-6391
Mailing Address - Country:US
Mailing Address - Phone:916-570-1500
Mailing Address - Fax:530-756-0727
Practice Address - Street 1:1791 OAK AVE STE C
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-1073
Practice Address - Country:US
Practice Address - Phone:530-756-7516
Practice Address - Fax:530-756-0727
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REEVES, D.D.S. AND LAVALLEY, D.D.S., A DENTAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-07
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty