Organization
RICKE DDS PLLC
Active
Other names
Lake Boone Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATT J RICKE DDS (MANAGER)
(919) 781-8610
Entity
Organization
Contact information
Practice address
2310 MYRON DR, RALEIGH, NC 27607-0059
(919) 781-8610
Mailing address
512 FALLON GROVE WAY, RALEIGH, NC 27608-1879
(904) 307-1239
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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