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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