Provider Demographics
NPI:1013916444
Name:RITCHIE DENTAL GROUP, P.A.
Entity type:Organization
Organization Name:RITCHIE DENTAL GROUP, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GREG
Authorized Official - Middle Name:A
Authorized Official - Last Name:RITCHIE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:830-693-8833
Mailing Address - Street 1:1000 MARBLE HTS
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-4543
Mailing Address - Country:US
Mailing Address - Phone:830-693-8833
Mailing Address - Fax:830-798-8691
Practice Address - Street 1:1000 MARBLE HTS
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-4543
Practice Address - Country:US
Practice Address - Phone:830-693-8833
Practice Address - Fax:830-798-8691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX201611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherBLUE CROSS BLUE SHIELD OF TEXAS
TX=========OtherDELTA DENTAL