MEDICARE: STEVEN J. RITZI, D.D.S., INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	30-019369	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639406820
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEVEN J. RITZI, D.D.S., INC.

Provider Business Mailing Address
First Line	:	235 S GARBER DR
Second Line	:
City	:	TIPP CITY
State	:	OH
Zip	:	45371-1183
Country	:	US
Telephone Number	:	937-667-2314
Fax Number	:	937-667-7278

Provider Business Practice Location Address
First Line	:	235 S GARBER DR
Second Line	:
City	:	TIPP CITY
State	:	OH
Zip	:	45371-1183
Country	:	US
Telephone Number	:	937-667-2314
Fax Number	:	937-667-7278

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEVEN J. RITZI
Credential	:	D.D.S.
Telephone Number	:	937-667-2314

Provider Enumeration Date	:	11/09/2009
Last Update Date	:	11/09/2009

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