Healthcare Provider Details

I. General information

NPI: 1245420751
Provider Name (Legal Business Name): RITTER FAMILY DENTISTRY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 02/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 ELK DR. SUITE 2
MINOT ND
58701
US

IV. Provider business mailing address

2615 ELK DR. SUITE 2
MINOT ND
58701
US

V. Phone/Fax

Practice location:
  • Phone: 701-837-1050
  • Fax: 701-837-6350
Mailing address:
  • Phone: 701-837-1050
  • Fax: 701-837-6350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number1982
License Number StateND

VIII. Authorized Official

Name: DR. STEPHANIE A. RITTER
Title or Position: DENTIST
Credential: DDS
Phone: 701-837-1050