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General NPI Number Information
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NPI Number | 1083899496
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Entity Type | Individual
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Provider Name | JEFFREY SCOTT RYTHER D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 01/03/2008
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Last Update Date | 01/03/2008
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Provider Practice Location Address
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Address Line | 1901 S WEBSTER AVE SUITE 8
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City | GREEN BAY
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State | WI
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Zip | 54301-2281
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Country | US
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Telephone | 920-437-1499
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Fax | 920-437-5333
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Provider Business Mailing Address
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Address Line | 1901 SOUTH WEBSTER SUITE 8
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City | GREEN BAY
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State | WI
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Zip | 54301
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Country | US
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Telephone | 920-437-1499
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Fax | 920-437-5333
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 2724
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License Number State | WI
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