Provider Demographics
NPI:1659474922
Name:REEVE, JOSEPH G (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:G
Last Name:REEVE
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 1:1131 6 STREET NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-1824
Mailing Address - Country:US
Mailing Address - Phone:507-281-2433
Mailing Address - Fax:
Practice Address - Street 1:1131 6 STREET NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-1824
Practice Address - Country:US
Practice Address - Phone:507-281-2433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN93661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN9366OtherSTATE LICENSE