Provider Demographics
NPI:1356062012
Name:EVERETT, REECE JOEL (DMD)
Entity type:Individual
Prefix:DR
First Name:REECE
Middle Name:JOEL
Last Name:EVERETT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 ENTERPRISE DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-2762
Mailing Address - Country:US
Mailing Address - Phone:662-550-2310
Mailing Address - Fax:662-586-2995
Practice Address - Street 1:4240 BALMORAL DR SW STE 200
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5633
Practice Address - Country:US
Practice Address - Phone:256-852-9878
Practice Address - Fax:662-586-2995
Is Sole Proprietor?:No
Enumeration Date:2022-09-09
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALD-0007109-C11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice