Provider Demographics
NPI:1720521552
Name:SIERRA-REYES, KEYLA (DMD)
Entity Type:Individual
Prefix:
First Name:KEYLA
Middle Name:
Last Name:SIERRA-REYES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:KEYLA
Other - Middle Name:
Other - Last Name:SIERRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:304 N WATER ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3374
Mailing Address - Country:US
Mailing Address - Phone:717-299-6372
Mailing Address - Fax:717-325-8057
Practice Address - Street 1:101 S 9TH ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-5108
Practice Address - Country:US
Practice Address - Phone:717-450-7015
Practice Address - Fax:717-273-2817
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0410551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice