Provider Demographics
NPI:1679681084
Name:RITROVATO, ROBERT R (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:R
Last Name:RITROVATO
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 1:306 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:PA
Mailing Address - Zip Code:19405-1809
Mailing Address - Country:US
Mailing Address - Phone:610-275-7800
Mailing Address - Fax:610-275-6527
Practice Address - Street 1:306 E 4TH ST
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:PA
Practice Address - Zip Code:19405-1809
Practice Address - Country:US
Practice Address - Phone:610-275-7800
Practice Address - Fax:610-275-6527
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020732L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice