Provider Demographics
NPI:1245420751
Name:RITTER FAMILY DENTISTRY, LLC
Entity Type:Organization
Organization Name:RITTER FAMILY DENTISTRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RITTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:701-837-1050
Mailing Address - Street 1:2615 ELK DR.
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58701
Mailing Address - Country:US
Mailing Address - Phone:701-837-1050
Mailing Address - Fax:701-837-6350
Practice Address - Street 1:2615 ELK DR.
Practice Address - Street 2:SUITE 2
Practice Address - City:MINOT
Practice Address - State:ND
Practice Address - Zip Code:58701
Practice Address - Country:US
Practice Address - Phone:701-837-1050
Practice Address - Fax:701-837-6350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1982261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND41431Medicaid
ND94-9376OtherBCBS OF ND