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Organization
EAGLE MOUNTIAN FAMILY DENTAL, PC
Active
Organization
EAGLE MOUNTIAN FAMILY DENTAL, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE LARRY REEVES D.D.S. (PRESIDENT SECRETARY TREASURER)
(817) 444-3890
Entity
Organization
Contact information
Practice address
116 DENVER TRL, AZLE, TX 76020-3614
(817) 444-3890
Mailing address
116 DENVER TRL, AZLE, TX 76020-3614
(817) 444-3890
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
20177
TX
Other
Enumeration date
10/09/2006
Last updated
08/22/2020
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