Provider Demographics
NPI:1154431450
Name:RITTER, ROBERT PATRICK (DDS)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:PATRICK
Last Name:RITTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9122 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53222-4600
Mailing Address - Country:US
Mailing Address - Phone:414-771-8778
Mailing Address - Fax:414-774-0204
Practice Address - Street 1:9122 W CENTER ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53222-4600
Practice Address - Country:US
Practice Address - Phone:414-771-8778
Practice Address - Fax:414-774-0204
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2344015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI33394800Medicaid