Provider Demographics
NPI:1306602875
Name:RITTER & BACKSTROM DENTISTRY PLLC
Entity type:Organization
Organization Name:RITTER & BACKSTROM DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MILES
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:BACKSTROM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:662-397-3749
Mailing Address - Street 1:726 HIGHLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-8901
Mailing Address - Country:US
Mailing Address - Phone:662-397-3749
Mailing Address - Fax:
Practice Address - Street 1:2690 HIGHWAY 145
Practice Address - Street 2:
Practice Address - City:SALTILLO
Practice Address - State:MS
Practice Address - Zip Code:38866-6941
Practice Address - Country:US
Practice Address - Phone:662-869-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental