Provider Demographics
NPI:1174800940
Name:PATETTA, LOUIS JOSEPH JR (DDS)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:JOSEPH
Last Name:PATETTA
Suffix:JR
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 1:1601 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3464
Mailing Address - Country:US
Mailing Address - Phone:775-329-1855
Mailing Address - Fax:775-324-4110
Practice Address - Street 1:1601 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3464
Practice Address - Country:US
Practice Address - Phone:775-329-1855
Practice Address - Fax:775-324-4110
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV887122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist