Individual
DR. JEFF L RICKABAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.D.S., P.A.
Contact information
Practice address
1551 WESTBROOK PLAZA DR, SUITE 103, WINSTON SALEM, NC 27103-1355
(336) 760-9229
(336) 760-2263
Mailing address
1551 WESTBROOK PLAZA DR, SUITE 103, WINSTON SALEM, NC 27103-1355
(336) 760-9229
(336) 760-2263
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5949
NC
Other
Enumeration date
06/28/2006
Last updated
07/08/2007
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