# EDWARD L RICK DDS,MS,PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1588818736
- **Authorized official:** MS. KIMBERLY A HOSKINS (RECEPTIONIST)
- **Authorized official phone:** (309) 682-5863

## Contact information

- **Practice address:** 6926 N UNIVERSITY ST STE C, PEORIA, IL 61614-1728
- **Practice address phone:** (309) 692-5863
- **Practice address fax:** (309) 689-3031
- **Mailing address:** 6926 N UNIVERSITY ST STE C, PEORIA, IL 61614-1728
- **Mailing address phone:** (309) 692-5863
- **Mailing address fax:** (309) 689-3031

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 021-000885 | IL | Yes |

## Other

- **Enumeration date:** 11/13/2008
- **Last updated:** 11/13/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1003466/101355 | — | IL |