Provider Demographics
NPI:1609929207
Name:RITCHEY, DANIEL LYNN (DMD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:LYNN
Last Name:RITCHEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2189 RAYSTOWN RD.
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:PA
Mailing Address - Zip Code:15537-4956
Mailing Address - Country:US
Mailing Address - Phone:814-652-5517
Mailing Address - Fax:
Practice Address - Street 1:2189 RAYSTOWN RD
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:PA
Practice Address - Zip Code:15537-4956
Practice Address - Country:US
Practice Address - Phone:814-652-5517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0191081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice