Provider Demographics
NPI:1265494496
Name:REEVES, DAVID ROY (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROY
Last Name:REEVES
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 OVERLOOK BND
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-2976
Mailing Address - Country:US
Mailing Address - Phone:512-528-1400
Mailing Address - Fax:512-528-1466
Practice Address - Street 1:209 DENALI PASS
Practice Address - Street 2:SUITE A
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613
Practice Address - Country:US
Practice Address - Phone:512-528-1400
Practice Address - Fax:512-528-1466
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX216531223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics