Organization
REAVLEY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL D REAVLEY (OFFICE MANAGER)
(417) 682-3393
Entity
Organization
Contact information
Practice address
804 GULF STREET, LAMAR, MO 64759-6475
(417) 682-3393
(417) 682-6659
Mailing address
804 GULF STREET, LAMAR, MO 64759
(417) 682-3393
(417) 683-6659
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/13/2021
Last updated
12/21/2021
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