Provider Demographics
NPI:1508041138
Name:RITSCO, HEIDI C (DDS)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:C
Last Name:RITSCO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 COMMERCIAL CENTER BLVD
Mailing Address - Street 2:STE 101
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494
Mailing Address - Country:US
Mailing Address - Phone:281-392-8450
Mailing Address - Fax:281-392-8451
Practice Address - Street 1:2910 COMMERCIAL CENTER BLVD
Practice Address - Street 2:STE 101
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494
Practice Address - Country:US
Practice Address - Phone:281-392-8450
Practice Address - Fax:281-392-8451
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21552122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist