# REAVES DENTAL PRACTICE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124264866
- **Authorized official:** DR. JUSTIN J REAVES DDS (OWNER - GENERAL DENTIST)
- **Authorized official phone:** (315) 736-0139

## Contact information

- **Practice address:** 4301 MIDDLE SETTLEMENT RD, NEW HARTFORD, NY 13413-5317
- **Practice address phone:** (315) 736-0139
- **Practice address fax:** (315) 768-6148
- **Mailing address:** 4301 MIDDLE SETTLEMENT RD, NEW HARTFORD, NY 13413-5317
- **Mailing address phone:** (315) 736-0139
- **Mailing address fax:** (315) 768-6148

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 032955 | NY | — |
| 261QD0000X | Dental Clinic/Center | 053015 | NY | Yes |

## Other

- **Enumeration date:** 12/31/2008
- **Last updated:** 11/05/2014