Provider Demographics
NPI:1083724033
Name:RITZ, STEPHEN WESLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:WESLEY
Last Name:RITZ
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 1:889 MEADOW DRIVE
Mailing Address - Street 2:
Mailing Address - City:MT GILEAD
Mailing Address - State:OH
Mailing Address - Zip Code:43338
Mailing Address - Country:US
Mailing Address - Phone:419-947-9547
Mailing Address - Fax:419-947-9521
Practice Address - Street 1:889 MEADOW DRIVE
Practice Address - Street 2:
Practice Address - City:MT GILEAD
Practice Address - State:OH
Practice Address - Zip Code:43338
Practice Address - Country:US
Practice Address - Phone:419-947-9547
Practice Address - Fax:419-947-9521
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2009-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300170211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice