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NPI Code Detail

MEDICARE: GAGE EVANS RITTER DDS

MEDICARE:   GAGE EVANS RITTER  DDS
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
1122300000XDentist6968LA

General Provider Information

NPI Number : 1851854723
Entity Type Code : Individual
Provider Name (Legal Business Name) : GAGE EVANS RITTER DDS
Provider Business Mailing Address
First Line : 16606 WINDMILL LN
Second Line :
City : IOWA
State : LA
Zip : 70647-6343
Country : US
Telephone Number : 337-912-5176
Fax Number :
Provider Business Practice Location Address
First Line : 4243 AMBASSADOR CAFFERY PKWY STE 118
Second Line :
City : LAFAYETTE
State : LA
Zip : 70508-7268
Country : US
Telephone Number : 337-422-3587
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2019
Last Update Date : 09/24/2019

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Directions to “ GAGE EVANS RITTER DDS” Practice Location

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