Provider Demographics
NPI:1750090122
Name:SCOTT J RIBITCH DDS PLLC
Entity type:Organization
Organization Name:SCOTT J RIBITCH DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:RIBITCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:734-277-2057
Mailing Address - Street 1:8970 STERLING HILLS DR NE
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:MI
Mailing Address - Zip Code:49341-8746
Mailing Address - Country:US
Mailing Address - Phone:734-277-2057
Mailing Address - Fax:
Practice Address - Street 1:2425 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:MI
Practice Address - Zip Code:48838-8259
Practice Address - Country:US
Practice Address - Phone:616-754-2274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-15
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental