Healthcare Provider Details

I. General information

NPI: 1962593087
Provider Name (Legal Business Name): HAROLD KEITH RITTER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 WEST SEVENTH
HOISINGTON KS
67544
US

IV. Provider business mailing address

PO BOX 186 165 WEST SEVENTH
HOISINGTON KS
67544
US

V. Phone/Fax

Practice location:
  • Phone: 620-653-2511
  • Fax: 620-653-2511
Mailing address:
  • Phone: 620-653-2511
  • Fax: 620-653-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number3879
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: