Basic Information
| Provider Information | |||||||||
| NPI: | 1174661961 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | REITZ AND RIZER DENTAL CORP | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 750 W GONZALES RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | OXNARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930360700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059836010 | ||||||||
| FaxNumber: | 8059837352 | ||||||||
| Practice Location | |||||||||
| Address1: | 750 W GONZALES RD STE 200 | ||||||||
| Address2: | |||||||||
| City: | OXNARD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930360700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8059836010 | ||||||||
| FaxNumber: | 8059837352 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | REITZ | ||||||||
| AuthorizedOfficialFirstName: | RONALD | ||||||||
| AuthorizedOfficialMiddleName: | G. | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8059836010 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | D.D.S. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | 22658 | CA | Y | 193400000X SINGLE SPECIALTY GROUP | Dental Providers | Dentist |
No ID Information.