Provider Demographics
NPI:1366549552
Name:DITO, RENEE BEATRICE (RDH)
Entity type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:BEATRICE
Last Name:DITO
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 RIVER CREEK PLACE
Mailing Address - Street 2:
Mailing Address - City:CARRBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27510
Mailing Address - Country:US
Mailing Address - Phone:919-932-9561
Mailing Address - Fax:
Practice Address - Street 1:2628 NEW BERN AVENUE
Practice Address - Street 2:NEW BERN RIDGE DENTAL CENTER
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610
Practice Address - Country:US
Practice Address - Phone:919-250-2930
Practice Address - Fax:919-231-8077
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4536124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist