Provider Demographics
NPI:1356662951
Name:REEVES, CARTER CORNET (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARTER
Middle Name:CORNET
Last Name:REEVES
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7764 ARMISTEAD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-1919
Mailing Address - Country:US
Mailing Address - Phone:703-339-5090
Mailing Address - Fax:703-339-1068
Practice Address - Street 1:7764 ARMISTEAD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LORTON
Practice Address - State:VA
Practice Address - Zip Code:22079-1919
Practice Address - Country:US
Practice Address - Phone:703-339-5090
Practice Address - Fax:703-339-1068
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014128581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice