Provider Demographics
NPI:1679249056
Name:REBECCA E REEVES DMD, PA
Entity type:Organization
Organization Name:REBECCA E REEVES DMD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:919-500-3909
Mailing Address - Street 1:5700 LENA BUNN CT
Mailing Address - Street 2:
Mailing Address - City:ROLESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27571-9526
Mailing Address - Country:US
Mailing Address - Phone:919-500-3909
Mailing Address - Fax:
Practice Address - Street 1:8300 FALLS OF NEUSE RD STE 114
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615-3450
Practice Address - Country:US
Practice Address - Phone:919-500-3909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-17
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty