Provider Demographics
NPI:1306193461
Name:REATEGUI, PATRICIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:
Last Name:REATEGUI
Suffix:
Gender:F
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:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22555-0279
Mailing Address - Country:US
Mailing Address - Phone:540-659-6650
Mailing Address - Fax:
Practice Address - Street 1:623 GARRISONVILLE RD
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22554-3710
Practice Address - Country:US
Practice Address - Phone:540-659-6650
Practice Address - Fax:540-657-0576
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-08
Last Update Date:2014-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413627122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist