Provider Demographics
NPI:1174641211
Name:AARON P REEVES, DMD DENTAL CORP.
Entity Type:Organization
Organization Name:AARON P REEVES, DMD DENTAL CORP.
Other - Org Name:CHILDREN'S DENTAL CENTER OF ELK GROVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:P
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:916-683-7645
Mailing Address - Street 1:9565 LAGUNA SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7961
Mailing Address - Country:US
Mailing Address - Phone:916-683-7645
Mailing Address - Fax:916-683-4004
Practice Address - Street 1:9565 LAGUNA SPRINGS DR
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-7961
Practice Address - Country:US
Practice Address - Phone:916-683-7645
Practice Address - Fax:916-683-4004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA477851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty