Provider Demographics
NPI:1861402364
Name:REITZ, JOHN VINCENT (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:VINCENT
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 1:30 COMMERCE DRIVE
Mailing Address - Street 2:STE 2
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19610
Mailing Address - Country:US
Mailing Address - Phone:610-320-9993
Mailing Address - Fax:610-320-9042
Practice Address - Street 1:30 COMMERCE DRIVE
Practice Address - Street 2:STE 2
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19610
Practice Address - Country:US
Practice Address - Phone:610-320-9993
Practice Address - Fax:610-320-9042
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA021566122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist