Provider Demographics
NPI:1447463955
Name:G. BRIAN REICHGOTT D.D.S. P.C.
Entity type:Organization
Organization Name:G. BRIAN REICHGOTT D.D.S. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROSTHODONTICS
Authorized Official - Prefix:DR
Authorized Official - First Name:G.
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:REICHGOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DDSPC
Authorized Official - Phone:540-434-1904
Mailing Address - Street 1:129 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22801-3751
Mailing Address - Country:US
Mailing Address - Phone:540-434-1904
Mailing Address - Fax:540-433-7684
Practice Address - Street 1:129 UNIVERSITY BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-3751
Practice Address - Country:US
Practice Address - Phone:540-434-1904
Practice Address - Fax:540-433-7684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010059101223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty