Boren, Culberson Reeves

Boren, Culberson Reeves is an sole proprietor health care provider with primary practice located at 7916 S Broadway Ave Ste 150, Tyler TX 75703-5274. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Boren, Culberson Reeves can be contacted via phone (903) 581-2198.

Contact Information

Primary practice address
7916 S Broadway Ave Ste 150 Tyler TX 75703-5274
Fax: (903) 581-9571
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 13063 Texas
Dental Providers / Pediatric Dentistry 1223P0221X 013063 Texas

Profile Details

NPI number 1497837587
LBN Legal business name Boren, Culberson Reeves
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 19th, 2006
Last updated Aug 16th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497837587 NPPES
Texas MEDICAID 008045901
Texas Other 751899269

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