Provider Demographics
NPI:1720069974
Name:REBELLATO, GIUSEPPE (DDS)
Entity Type:Individual
Prefix:DR
First Name:GIUSEPPE
Middle Name:
Last Name:REBELLATO
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 1:1470 PANTOPS MOUNTAIN PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-4662
Mailing Address - Country:US
Mailing Address - Phone:434-984-1817
Mailing Address - Fax:434-817-1819
Practice Address - Street 1:1470 PANTOPS MOUNTAIN PL
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-4662
Practice Address - Country:US
Practice Address - Phone:434-984-1817
Practice Address - Fax:434-817-1819
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010078291223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics