Healthcare Provider Details

I. General information

NPI: 1487709473
Provider Name (Legal Business Name): RITTENHOUSE DENTISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 09/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 PINE ST
PHILADELPHIA PA
19103-6601
US

IV. Provider business mailing address

1801 PINE ST
PHILADELPHIA PA
19103-6601
US

V. Phone/Fax

Practice location:
  • Phone: 215-545-8600
  • Fax:
Mailing address:
  • Phone: 215-545-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDS017231L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS017231L
License Number StatePA

VIII. Authorized Official

Name: DR. JON L. RICHTER
Title or Position: PRESIDENT
Credential: D.M.D.,, PH.D.
Phone: 215-545-8600