Provider Demographics
NPI:1568980696
Name:REUTENAUER, ANNA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:REUTENAUER
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 1:123 YORK ST STE 4L
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5660
Mailing Address - Country:US
Mailing Address - Phone:203-782-8051
Mailing Address - Fax:
Practice Address - Street 1:298 BROAD ST
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-5853
Practice Address - Country:US
Practice Address - Phone:203-235-5588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2023-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11945122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist