Provider Demographics
NPI:1629361696
Name:RIBITCH, RAYMOND WILLIAM JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:WILLIAM
Last Name:RIBITCH
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1020 E ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-2911
Mailing Address - Country:US
Mailing Address - Phone:989-772-1344
Mailing Address - Fax:989-779-9770
Practice Address - Street 1:1020 E ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2911
Practice Address - Country:US
Practice Address - Phone:989-772-1344
Practice Address - Fax:989-779-9770
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI209010204101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice