Provider Demographics
NPI:1851306591
Name:RITCHEY, HALEY SUZANNE (DDS)
Entity Type:Individual
Prefix:DR
First Name:HALEY
Middle Name:SUZANNE
Last Name:RITCHEY
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 1:3491 TRINITY DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:LOS ALAMOS
Mailing Address - State:NM
Mailing Address - Zip Code:87544-2398
Mailing Address - Country:US
Mailing Address - Phone:505-662-7786
Mailing Address - Fax:
Practice Address - Street 1:3491 TRINITY DR
Practice Address - Street 2:SUITE E
Practice Address - City:LOS ALAMOS
Practice Address - State:NM
Practice Address - Zip Code:87544-2398
Practice Address - Country:US
Practice Address - Phone:505-662-7786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD19691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice