Healthcare Provider Details

I. General information

NPI: 1437379260
Provider Name (Legal Business Name): RONALD P. RITUCCI DMD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 CHASE PKWY
WATERBURY CT
06708-3040
US

IV. Provider business mailing address

650 CHASE PKWY
WATERBURY CT
06708-3040
US

V. Phone/Fax

Practice location:
  • Phone: 203-573-8034
  • Fax: 203-753-1921
Mailing address:
  • Phone: 203-573-8034
  • Fax: 203-753-1921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number005721
License Number StateCT

VIII. Authorized Official

Name: DR. RONALD P RITUCCI
Title or Position: PRESIDENT
Credential: D.M.D.
Phone: 203-573-8034