Healthcare Provider Details

I. General information

NPI: 1669587986
Provider Name (Legal Business Name): NATHANIEL RITTER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8769 N MAIN ST SUITE 200
DAYTON OH
45415-1331
US

IV. Provider business mailing address

8769 N MAIN ST SUITE 200
DAYTON OH
45415-1331
US

V. Phone/Fax

Practice location:
  • Phone: 937-890-9600
  • Fax: 937-890-9915
Mailing address:
  • Phone: 937-890-9600
  • Fax: 937-890-9915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number30015795
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: