Provider Demographics
NPI:1154481018
Name:REINECK, PATRICK ANTHONY (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:ANTHONY
Last Name:REINECK
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 1:232 E. SECOND ST.
Mailing Address - Street 2:
Mailing Address - City:PORT CLINTON
Mailing Address - State:OH
Mailing Address - Zip Code:43452-1117
Mailing Address - Country:US
Mailing Address - Phone:419-734-2177
Mailing Address - Fax:
Practice Address - Street 1:232 E 2ND ST
Practice Address - Street 2:
Practice Address - City:PORT CLINTON
Practice Address - State:OH
Practice Address - Zip Code:43452-1117
Practice Address - Country:US
Practice Address - Phone:419-734-2177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20234122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist