MEDICARE: LLOYD K. RITCHIE, JR., DDS, PA

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	261QD0000X	Dental Clinic/Center	DN0011681	FL

General Provider Information

NPI Number	:	1841217668
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LLOYD K. RITCHIE, JR., DDS, PA

Provider Business Mailing Address
First Line	:	9320 N PALAFOX ST
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32534-3040
Country	:	US
Telephone Number	:	850-494-2292
Fax Number	:	850-494-6613

Provider Business Practice Location Address
First Line	:	9320 N PALAFOX ST
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32534-3040
Country	:	US
Telephone Number	:	850-494-2292
Fax Number	:	850-494-6613

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. DIANE RITCHIE
Credential	:
Telephone Number	:	850-494-2292

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	05/20/2008

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