Healthcare Provider Details
I. General information
NPI: 1790092682
Provider Name (Legal Business Name): CECIL RITER DDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/13/2010
Last Update Date: 09/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1441 KAPIOLANI BLVD STE 905
HONOLULU HI
96814-4402
US
IV. Provider business mailing address
1441 KAPIOLANI BLVD STE 905
HONOLULU HI
96814-4402
US
V. Phone/Fax
- Phone: 808-955-5922
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | 1734 |
| License Number State | HI |
VIII. Authorized Official
Name:
CECIL
FRANK
RITER
Title or Position: PRESIDENT
Credential: DDS
Phone: 808-955-5922