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General NPI Number Information
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NPI Number | 1518229053
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Entity Type | Organization
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Legal Business Name | ALEXANDER E. RITCHEY DMD, MS LTD
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 06/11/2012
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Provider Practice Location Address
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Address Line | 1713 CAMPBELL ST
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City | JOLIET
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State | IL
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Zip | 60435-5880
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Country | US
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Telephone | 815-725-9130
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Fax |
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Provider Business Mailing Address
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Address Line | 1713 CAMPBELL ST
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City | JOLIET
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State | IL
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Zip | 60435-5880
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Country | US
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Telephone | 815-725-9130
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALEXANDER E RITCHEY
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Credential |
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Telephone | 815-725-9130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 021.002064
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License Number State | IL
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