Organization
DAVID REAGAN & ROBERT SMITH DDS SMITH ROBERT F GEN PTR.
Active
Other names
North Heacock Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L REAGAN DDS (OWNER/PARTNER)
(951) 247-7040
Entity
Organization
Contact information
Practice address
11401 HEACOCK ST, SUITE 320, MORENO VALLEY, CA 92557-9998
(951) 247-7040
(951) 247-5092
Mailing address
11401 HEACOCK ST, SUITE 320, MORENO VALLEY, CA 92557-9998
(951) 247-7040
(951) 247-5092
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
DB31029
CA
1223G0001X
General Practice Dentistry
Primary
DH32166
CA
Other
Enumeration date
12/01/2006
Last updated
01/20/2020
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