Organization
REEVES, D.D.S. AND LAVALLEY, D.D.S., A DENTAL CORPORATION
Active
Other names
Kids Care Dental & Orthodontics - Stockton
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK BOYES (COO)
(916) 570-1500
Entity
Organization
Contact information
Practice address
3485 BROOKSIDE RD, STE 101, STOCKTON, CA 95219-1757
(209) 957-4386
Mailing address
3100 ZINFANDEL DR STE 400, RANCHO CORDOVA, CA 95670-6391
(916) 570-1500
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
06/13/2013
Last updated
02/09/2023
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