Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 8243 | SC |
NPI | 1083001598 |
---|---|
Provider Name | Dr. Rachel B Rittenberg |
First Address | Sullivans Island, SC 29482-7701 |
Second Address | Sullivans Island, SC 29482-7701 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2015 |
Last Update Date | 13/08/2015 |