Healthcare Provider Details

I. General information

NPI: 1043260367
Provider Name (Legal Business Name): MARTIN ANTHONY HRITZ D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 01/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26495 ROYALTON RD
COLUMBIA STATION OH
44028-9402
US

IV. Provider business mailing address

23240 SNELL RD
COLUMBIA STATION OH
44028-9625
US

V. Phone/Fax

Practice location:
  • Phone: 440-236-5478
  • Fax:
Mailing address:
  • Phone: 440-238-7482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number20967
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: