Provider Demographics
NPI:1689678948
Name:RITUCCI, ROBERT A (DMD, CAGS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:RITUCCI
Suffix:
Gender:M
Credentials:DMD, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 LONG POND RD
Mailing Address - Street 2:STE 122
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2642
Mailing Address - Country:US
Mailing Address - Phone:508-747-4667
Mailing Address - Fax:
Practice Address - Street 1:110 LONG POND RD
Practice Address - Street 2:STE 122
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2642
Practice Address - Country:US
Practice Address - Phone:508-747-4667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA175911223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics