Individual
DR. NATHANIEL D TRICKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
0401412914
VA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
12010200A
IN
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DE00011016
WA
Other
Enumeration date
12/15/2005
Last updated
08/23/2010
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