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General NPI Number Information
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NPI Number | 1851754899
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Entity Type | Individual
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Provider Name | MARK ALLEN RITCHIE D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/29/2016
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Last Update Date | 10/05/2016
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Provider Practice Location Address
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Address Line | 1313 W SEMINARY ST 200
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City | RICHLAND CENTER
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State | WI
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Zip | 53581-2067
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Country | US
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Telephone | 608-647-8868
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Fax |
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Provider Business Mailing Address
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Address Line | 33636 VALLEY LN
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City | LONE ROCK
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State | WI
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Zip | 53556-4168
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Country | US
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Telephone | 715-401-1999
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 1001334 - 15
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License Number State | WI
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