Provider Demographics
NPI:1003807140
Name:REITZ, RONALD G (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:G
Last Name:REITZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 W GONZALES RD
Mailing Address - Street 2:200
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-9025
Mailing Address - Country:US
Mailing Address - Phone:805-983-6010
Mailing Address - Fax:805-983-7952
Practice Address - Street 1:750 W GONZALES RD
Practice Address - Street 2:200
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-9025
Practice Address - Country:US
Practice Address - Phone:805-983-6010
Practice Address - Fax:805-983-7952
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA226581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice