MEDICARE: DAVID BRUCE RITCHIE D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	19665	CA

General Provider Information

NPI Number	:	1235128687
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID BRUCE RITCHIE D.D.S.

Provider Business Mailing Address
First Line	:	PO BOX 501
Second Line	:	1811 LOCKHART BLVD
City	:	MURPHYS
State	:	CA
Zip	:	95247-0501
Country	:	US
Telephone Number	:	209-728-3959
Fax Number	:	209-728-2958

Provider Business Practice Location Address
First Line	:	272 W SAINT CHARLES ST
Second Line	:
City	:	SAN ANDREAS
State	:	CA
Zip	:	95249-9664
Country	:	US
Telephone Number	:	209-754-3816
Fax Number	:	209-754-3818

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	07/08/2007

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