Provider Demographics
NPI:1548524606
Name:RITZCOVAN, NICHOLAS JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:JOSEPH
Last Name:RITZCOVAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 BAILEY AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4533
Mailing Address - Country:US
Mailing Address - Phone:203-431-3901
Mailing Address - Fax:
Practice Address - Street 1:31 BAILEY AVE
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4533
Practice Address - Country:US
Practice Address - Phone:203-431-3901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-03
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT011015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist