Individual
DR. TERRY JUSTIN REAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
13302 S MEMORIAL DR, BIXBY, OK 74008-3114
(918) 369-3990
(918) 369-8505
Mailing address
13302 S MEMORIAL DR, BIXBY, OK 74008-3114
(918) 369-3990
(918) 369-8505
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4843
OK
Other
Enumeration date
03/23/2006
Last updated
06/23/2008
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