Healthcare Provider Details

I. General information

NPI: 1104133263
Provider Name (Legal Business Name): CECIL FRANK RITER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2010
Last Update Date: 09/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 KAPIOLANI BLVD SUITE 905
HONOLULU HI
96814-4402
US

IV. Provider business mailing address

1441 KAPIOLANI BLVD
HONOLULU HI
96814-4402
US

V. Phone/Fax

Practice location:
  • Phone: 808-955-5922
  • Fax: 808-955-5944
Mailing address:
  • Phone: 808-955-5922
  • Fax: 808-955-5944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1734
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: