Individual
DR. BRENTON A REAVLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4151 N MULBERRY DR, SUITE 230, KANSAS CITY, MO 64116-4447
(816) 326-8204
(816) 326-8431
Mailing address
4151 N MULBERRY DR, SUITE 230, KANSAS CITY, MO 64116-4447
(816) 326-8204
(816) 326-8431
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2007014548
MO
1223E0200X
Endodontics
Primary
2007014548
MO
Other
Enumeration date
06/03/2009
Last updated
07/20/2009
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