Individual
DR. REINALDO VALLECILLO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1621 LIVE OAK ST, BEAUFORT, NC 28516-1520
(252) 728-2025
(252) 728-3326
Mailing address
1621 LIVE OAK ST, BEAUFORT, NC 28516-1520
(252) 728-2025
(252) 728-3326
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4545
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8998763
—
NC
Enumeration date
08/11/2006
Last updated
07/08/2007
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