| Reaves Dental Practice, Pllc | |
|
4301 Middle Settlement Rd New Hartford NY 13413-5317 | |
| (315) 736-0139 | |
| (315) 768-6148 |
| Full Name | Reaves Dental Practice, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4301 Middle Settlement Rd, New Hartford, New York |
| Authorized Official Name and Position | Justin J Reaves (OWNER - GENERAL DENTIST) |
| Authorized Official Contact | 3157360139 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Reaves Dental Practice, Pllc 4301 Middle Settlement Rd New Hartford NY 13413-5317 Ph: (315) 736-0139 | Reaves Dental Practice, Pllc 4301 Middle Settlement Rd New Hartford NY 13413-5317 Ph: (315) 736-0139 |
| NPI Number | 1124264866 |
|---|---|
| Provider Enumeration Date | 12/31/2008 |
| Last Update Date | 11/05/2014 |
| Medicare PECOS PAC ID | 5294052924 |
|---|---|
| Medicare Enrollment ID | O20150318000152 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124264866 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 032955 (New York) | Secondary |
| 261QD0000X | Clinic/center - Dental | 053015 (New York) | Primary |
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