Healthcare Provider Details
I. General information
NPI: 1134346299
Provider Name (Legal Business Name): CECIL RITER DDS. INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/19/2007
Last Update Date: 06/02/2008
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 SUITE #905
HONOLULU HI
96814-4402
US
V. Phone/Fax
- Phone: 808-955-5922
- Fax: 808-955-5944
- Phone: 808-955-5922
- Fax: 808-955-5944
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 305R00000X |
| Taxonomy | Preferred Provider Organization |
| License Number | W20192900-01 |
| License Number State | HI |
VIII. Authorized Official
Name: DR.
CECIL
FRANK
RITER
Title or Position: PRESIDENT
Credential: DDS
Phone: 808-955-5922